Pediatrics- Hematologic Disorders

Question 1

What is Epistaxis

Answer 1

Blood nose

Question 2

What is ridk factor for a bloody nose

Answer 2

Trauma(picking or rubbing the nose)
Low humidity
What injury?
Medication, side effect, clotting factors

Question 3

What should the nurse do if a child has a bloody nose

Answer 3

Maintain, calm demeanor
Have child sit up with head, tilted slightly forward to prevent aspiration of blood
Apply pressure to the lower nose
If needed pet cotton into side of nose, that’s bleeding
Encourage breathing through their mouth
Apply ice

Question 4

How should a patient be sitting if they have a bloody nose

Answer 4

Slightly forward sitting up

Question 5

Why are adolescence at risk to iron deficiency anemia

Answer 5

Poor diet
Rapid growth
Menses
Obesity
Strenuous activity

Question 6

What are risk factors for getting iron deficiency anemia

Answer 6

Premature birth
Excessive cow milk
Poor diet
Infants : Gerd, pyloric stenosis
Older children : G.I. polyps, colitis
Adolescence : menorrhagia

Question 7

Findings in a patient with iron deficiency anemia

Answer 7

Pallor
Riddle, spoon shaped fingernails
Muscle weakness
Craving nonnutritive substances

Question 8

How does milk affect iron deficiency anemia?

Answer 8

Milk is not a good source of iron
Milk takes the place of iron, rich, solid foods

Question 9

By what age should you provide iron supplements for premature low, birthweight infant

Answer 9

By age of two months

Question 10

Play what age should you supply iron supplements if full-term baby is anemic

Answer 10

4 to 6 months

Question 11

What should the infants diet include if they are iron deficient, anemia to help absorb iron?

Answer 11

High iron in vitamin C

Question 12

How do you give iron supplements?

Answer 12

One hour before or two hours after milk to prevent decreased absorption
G.I. upset is common
Give with meals
Give with vitamin C
You strong with liquid to prevent staining of teeth

Question 13

What do you teach a patient who is taking iron supplements?

Answer 13

Expects stools to turn Tary Green
Brush teeth after oral dose to prevent staining

Question 14

What should infants be taking as their dietary source of iron

Answer 14

Iron fortified cereals in formula

Question 15

What is sickle cell disease?

Answer 15

A group of diseases in which abnormal sickle hemoglobulin replace his normal adult hemoglobulin

Question 16

What is sickle cell anemia?

Answer 16

The most common form of sickle cell disease, results of RBC sickling, which leads to increased blood viscosity obstruction of blood flow in tissue hypoxia

Question 17

What is the sickle cell trait

Answer 17

Child has genes but is asymptomatic

Question 18

What is sickle cell crisis?

Answer 18

Is the acute exacerbation of sickle cell anemia

Question 19

What does risk factors of sickle cell anemia?

Answer 19

Recessive genetic disorder
African-American
Children who have a tree, but do not manifest. The disease can pass to their offspring.

Question 20

Expected findings in a child with sickle cell anemia

Answer 20

Family history
Reports of pain
SOB
Pallor
Hands and feet cool to touch
Dizziness

Question 21

What is a vaso-occlusive crisis

Answer 21

A painful episode of sickle cell anemia

Question 22

What is an acute crisis of sickle cell anemia?

Answer 22

Usually related to dehydration and decreased oxygen

Severe pain
Swollen joints
Abdominal pain
Hematuria
Visual disturbances

Question 23

What is a chronic crisis of sickle cell anemia?

Answer 23

Increased risk of respiratory infection and osteomyelitis
Retinal detachment in blindness
Systolic murmur
Renal failure
Liver cirrhosis

Question 24

What is this Sequestration

Answer 24

Excessive pooling of blood primarily in the spleen, and sometimes in the liver

Question 25

What can happen when sequestration occurs?

Answer 25

Where do circulating blood volume results in hypervolemia and can progress to shock

Question 26

What is hypovolemic, shock signs and symptoms

Answer 26

Irritability Tachycardia Pallor Decrease urinary output Tachypnea Cool extremities Thready pulse

Question 27

What is in aplastic crisis in sickle cell anemia?

Answer 27

 Extreme anemia, as a result of temporary decrease RBC production Typically triggered by an infection

Question 28

What does hyper hemolytic crisis?

Answer 28

Increase rate of RBC destruction, leading to anemia, jaundice, or reticulosytosis

Question 29

How do you detect, sickle cell anemia?

Answer 29

CBC

Question 30

What is a transcranial Doppler test

Answer 30

Assess intracranial vascular flow and detect the risk for cerebrovascular accident CVA Annually performed on children ages 2 to 16 who have sickle cell disease

Question 31

What should the nurse do for a patient who has sickle cell anemia?

Answer 31

Promote rest to decrease oxygen consumption Administer oxygen, if hypoxia is President Administer IV fluids with electrolyte Caution, potassium replacement Administer packed red blood cells

Question 32

Medication’s for sickle cell anemia

Answer 32

Opioids and HydroXyurea Increases oxygenation to the cells

Question 33

How can sickle cell anemia cause stroke?

Answer 33

Sickle cells can occlude blood vessels

Question 34

What are signs and symptoms of stroke?

Answer 34

Seizures Abnormal behavior Weakness, or an ability to move extremity Slurred speech Visual changes

Question 35

What is a life-threatening complication of sickle cell anemia?

Answer 35

Acute chest syndrome Common in adolescence Look for pain Fever of, 101.3 or higher. Wheezing Retractions Decrease oxygen saturation

Question 36

What should the nurse do if a patient is in acute chest syndrome

Answer 36

May need a blood transfusion

Question 37

What is hemophilia?

Answer 37

 Bleeding disorders characterized by difficulty, controlling, bleeding, and deficiencies in clotting factors

Question 38

When is bleeding tendencies recognized in infancy

Answer 38

During circumcision

Question 39

What is hemophilia a

Answer 39

Deficiency of factor VIII REFERRED TO AS CLASSIC HEMOPHILIA Most common

Question 40

What is hemophilia B

Answer 40

Deficiency of factor IX Referred to as Christmas disease

Question 41

What is von Willebrand hemophilia?

Answer 41

Inherited lack of the von Willebrand factor proteins, characterized by the inability of platelets to aggregate

Question 42

Expected, finding in patient with hemophilia

Answer 42

Episodes of bleeding Excessive bleeding Impaired mobility Easy bruising Activity intolerance Bleeding gums Tarry stools

Question 43

How do you diagnose hemophilia

Answer 43

DNA testing detects classic hemophilia trait in females

Question 44

What are you do for a patient who has hemophilia?

Answer 44

Administer injections subcutaneous instead of IM Venipunctures our preferred Monitor for blood in urine and stool Do not administer aspirin

Question 45

What is DDAVP

Answer 45

Form of vasopressin that increases plasma factor VIII to treat hemophilia a

Question 46

What should you teach the patient about Hemophilia

Answer 46

Environment should be as safe as possible to prevent injury Set activity restrictions to avoid injury Low contact sports Soft, bristle, toothbrush Up-to-date identification Where medical identification

Question 47

How to control bleeding in hemophilia

Answer 47

Use Acreman, RICE Rest Ice Compression Elevation

Question 48

What can happen if there’s uncontrolled bleeding and hemophilia

Answer 48

Impending shock

Question 49

A nurse is providing teaching about the management of epistaxis to an adolescent, which of the following position should the nurse instruct the adolescent to take when experiencing a nosebleed Set up an lean forward Set up until the head up Lying supine position Lie in a prone position

Answer 49

Sit up and lean forward

Question 50

A nurse is providing teaching about Epistaxis to the parent of a school age child which of the following should the nurse include as an action to take when managing an episode of epistaxis (select) Press the nares together for at least 10 minutes Breathe through the nose until bleeding stops Pekka in or tissue into the nearis that is bleeding Apply warm cloth across the bridge of the nose Insert petroleum into the Nare after the bleeding stops

Answer 50

Press, the nares together for at least 10 minutes Pet, cotton or tissue into the nares that is bleeding

Question 51

A nurse is providing teaching to the parent of a child, who has a new prescription for liquid, oral iron supplements, which of the following statements by the parent indicates an understanding of the teaching “ I should take my child to the emergency department if his stools become dark” “ my child should avoid eating citrus fruits while taking the supplements” “ I should give the iron with milk to help prevent an upset stomach” “ my child to take supplement through the straw”

Answer 51

My child should take the supplement through a straw

Question 52

A nurse is preparing to administer iron dextran IM to a school age child who has iron deficiency anemia, which of the following actions by the nurse is appropriate Administer the dose in the deltoid muscle Use the Z track method when administering the dose Avoid injection more than 2 mL with each dose Massage the injection site for one minute after administering the dose

Answer 52

 Use the Z track method when administering the dose

Question 53

A nurse is caring for an infant who is screening test reveals a potential diagnosis of sickle cell disease, which of the following test should be performed to distinguish is the infant has a tree or the disease Sickle cell solubility test Hemoglobin electrophoresis Complete blood count Transcranial Doppler

Answer 53

Hemoglobin electrophoresis