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Flashcards in T3 - Blueprint 2 (Josh) Deck (54):
1

Hallmarks of DIC are -- and --

bleeding

clotting

2

What are the Vaso-occlusive complicatons w/ SCD?

Stroke

Pain assoc. w/ obstructed blood flow and ischemia

3

Why is the Spleen effected by SCD?

Splenic sequestration caused by pooled blood, which enlarges the spleen significantly.

Treat with blood transfusion.

4

Patho of DIC

When the clotting process gets started abnormally. Thrombin is made faster than body can neutralize it.

This is bad because the child is susceptible to uncontrollable hemorrhage into vital organs.

5

Why is iron deficiency anemia common in infancy?

cow's milk too soon

6

Hemophilia A and B are X-linked recessive disorders which means that -- are more likely to get it.

boys

- remember the Punnet Square

7

Pathophysiology of Kawasaki Disease

inflammation in the walls of medium-sized arteries throughout the body (including the coronary arteries, which supply blood to heart muscle)

8

What is the definitive test for SCD?

Hbg Electrophoresis

- mearsures the various HGBs
- differentiates b/t trait and anemia

9

--- is a secondary disorder of coagulation that occurs as a complication of a number of pathologic processes.

DIC (Disseminated Intravascular Coagulation)

10

What is the analgesia of choice for SCD pain?

IV morphine

11

Why is Kawasaki Disease serious?

can lead to MI

12

S/S of RHD:

What is Erythema Marginatum

Classic eruption of RF

Flat, macular, circular, distinct wavy border (chicken wire--no itching) on trunk or arms

13

Prevention of RHD?

uses ASPIRIN for polyarthitits (inflammation f joints)

14

Hemophilia --- is more common and is a deficiency in ---

A (80% of cases)

Factor VIII

15

Stopping a nose bleed

sit up and slightly lean forward

pinch bridge of nose--hold about 5 minutes;

*****longer if hemophilia

16

What is the drug of choice to fight infection w/ SCD clients?

Penicillin

17

What is one of the first S/S of Vaso-occlusive complications w/ SCD?

Hand and Foot Syndrome (dactylitis)

- sausage finger
- inflammation of an entire digit (finger/toe)

18

SCD problems:

Aplastic Crisis is caused by --- and leads to --- and ----

human parvo virus

lowered Hgb

lethargy

19

S/S of RHD:

What is SubQ Nodules?

Small, hard, nontender swellings

Contain Aschoff bodies

20

What are the Ophthalmic complications with SCD?

hemmhorage and retinal detachment that can lead to blindness

21

S/S of RHD:

What is Sydenhams Chorea?

sudden, aimless, purposeles movements

- relieved by rest and sleep

22

RICE treatment for Hemophila

Rest

Ice

Compression

Elevation

23

Prevention for Hemophilia clients:

padded crib

clutter-free (tripping)

soft bristle toothbrushes

immunizations

RICE (rest, ice, compression, elevation)

24

Screening tests for Hgb are limited because...

they are not specific for trait or anemia

25

--- is systematic vasculitis.

Kawasaki Disease

26

SCD is an --- disease with an average lifespan of ---

inherited

45 years

27

Hgb count for Iron Deficiency Anemia.

6-11 g/dL

28

What can be given to increase clotting w/ Hemophilia clients?

Factor VIII and Factor IX

via port-a-cath at home

29

S/S of Kawasaki Disease

High Fever

Red Eyes

Ring around Iris

Strawberry Tongue

Rash (skin peels off in flakes)

30

S/S of Endocarditis

Low grade, intermittent fever

Malaise

Joint Pain (arthralgia)

New Murmur

31

In Endocarditis, what happens tot the heart valve?

infection/inflammation makes it stenotic

- typically Mitral Valve

32

SCD clients will likely need a --- due to severe pain.

PCA pump

33

Jones Criteria (Major/Minor Manifestations of Rheumatic Heart Disease)

***memorize***

Major:
- Carditis
- Polyarthritis
- Sydenham's Chorea
- Erythema Marginatum
- SubQ Nodules

Minor:
- Fever
- Arthalgia
- Elevated Acute Phase Reactants
- Prolonged PR Interval

34

Complications from SCD

Ophthalmic Complications

Vaso-occlusive Crisis

Cardiomegally

Abd. Pain and GI dysfunction

ENLARGED SPLEEN

Stroke

35

Enlarged Spleen (caused by SCD) can lead to...

Anemia

Hypovolemic Shock

INFECTION

36

Normal RBCs live about --

Sickled RBCs live about --

3 mths

1 mth

37

What is the cure for SCD?

nothing

there is no cure, only treat symptoms
- controlling anemia
- relieving pain

38

In treating Sickle Cell Disease (SCD), what is key?

Hydration and Oxygenation

39

--- is a symptom of Rheumatic Fever.

Endocarditis

- bacterial infection/inflammation of heart valves and inner lining

40

What should we avoid w/ Hemophilia clients unless absolutely necessary?

Rectal temp

Skin puncture

41

Normal Hgb is ---.

With SCD, Hbg is ---

Normal = 11 gm/dL

SCD = 2-5 gm/dL

42

S/S of Hemophilia

Active bleeding

Hematomas

Hemarthrosis

Headache

Slurred Speech

Decreased LOC

43

With Hemophilia, why avoid a Hot/Warm compress?

increases bleeding to the site!

44

S/S of DIC

Petechiae

Purpura

Bleeding from openings in venipuncture site and surgical incision

Bleeding from umbilicus or trachea (newborn)

Bleeding evidence in GI

Hypotension

Organ dysfunction from infarction and ischemia

45

Why is infection a problem with SCD?

Spleen filters out infection

Spleen is one of the major organs affected by SCD due to blood sequestering in the organ

46

What is the key sign of Hemophilia?

hemoarthritis

- treat immediately
- rest, immobilize, elevate, supply ice

47

Treatment for Kawasaki Disease

High dose of IVIG and Salicylate therapy

ASPIRIN

48

How common is stroke w/ SCD children?

10%

49

Nursing considerations when giving PO Iron.

If tolerated, give on empty stomach (with juice NOT MILK)

Give with meals and start with reduced dose and gradually increase if GI disturbance occurs

Give with Vitamin C to increase absorption

Use straw to prevent staining of teeth

Stools will be tarry green--this is normal

Brush teeth after dose to minimize/prevent staining

50

What helps keep SCD kids healthy?

good nutrition (folic acid)
- (though they can eat normal food)

****important b/c even a little cold can make them very ill

51

Sickle Cell Crisis is triggered by --- or --- and signs include --- and ---

viral infection

depletion of folic acid

profound anemia

pallor

52

--- -- -- follows strep when it is not treated properly.

Rheumatic Heart Disease

53

Treatment for Endocarditis

Prophylaxis Antibiotics (Penicillin best)

- especially BEFORE dentistry

54

In Kawasaki Disease, dilation of the Aorta from inflammation leads to ---

aneurysm