Flashcards in T3 - Blueprint 2 (Josh) Deck (54):
Hallmarks of DIC are -- and --
What are the Vaso-occlusive complicatons w/ SCD?
Pain assoc. w/ obstructed blood flow and ischemia
Why is the Spleen effected by SCD?
Splenic sequestration caused by pooled blood, which enlarges the spleen significantly.
Treat with blood transfusion.
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.
Why is iron deficiency anemia common in infancy?
cow's milk too soon
Hemophilia A and B are X-linked recessive disorders which means that -- are more likely to get it.
- remember the Punnet Square
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)
What is the definitive test for SCD?
- mearsures the various HGBs
- differentiates b/t trait and anemia
--- is a secondary disorder of coagulation that occurs as a complication of a number of pathologic processes.
DIC (Disseminated Intravascular Coagulation)
What is the analgesia of choice for SCD pain?
Why is Kawasaki Disease serious?
can lead to MI
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
Prevention of RHD?
uses ASPIRIN for polyarthitits (inflammation f joints)
Hemophilia --- is more common and is a deficiency in ---
A (80% of cases)
Stopping a nose bleed
sit up and slightly lean forward
pinch bridge of nose--hold about 5 minutes;
*****longer if hemophilia
What is the drug of choice to fight infection w/ SCD clients?
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)
Aplastic Crisis is caused by --- and leads to --- and ----
human parvo virus
S/S of RHD:
What is SubQ Nodules?
Small, hard, nontender swellings
Contain Aschoff bodies
What are the Ophthalmic complications with SCD?
hemmhorage and retinal detachment that can lead to blindness
S/S of RHD:
What is Sydenhams Chorea?
sudden, aimless, purposeles movements
- relieved by rest and sleep
RICE treatment for Hemophila
Prevention for Hemophilia clients:
soft bristle toothbrushes
RICE (rest, ice, compression, elevation)
Screening tests for Hgb are limited because...
they are not specific for trait or anemia
--- is systematic vasculitis.
SCD is an --- disease with an average lifespan of ---
Hgb count for Iron Deficiency Anemia.
What can be given to increase clotting w/ Hemophilia clients?
Factor VIII and Factor IX
via port-a-cath at home
S/S of Kawasaki Disease
Ring around Iris
Rash (skin peels off in flakes)
S/S of Endocarditis
Low grade, intermittent fever
Joint Pain (arthralgia)
In Endocarditis, what happens tot the heart valve?
infection/inflammation makes it stenotic
- typically Mitral Valve
SCD clients will likely need a --- due to severe pain.
Jones Criteria (Major/Minor Manifestations of Rheumatic Heart Disease)
- Sydenham's Chorea
- Erythema Marginatum
- SubQ Nodules
- Elevated Acute Phase Reactants
- Prolonged PR Interval
Complications from SCD
Abd. Pain and GI dysfunction
Enlarged Spleen (caused by SCD) can lead to...
Normal RBCs live about --
Sickled RBCs live about --
What is the cure for SCD?
there is no cure, only treat symptoms
- controlling anemia
- relieving pain
In treating Sickle Cell Disease (SCD), what is key?
Hydration and Oxygenation
--- is a symptom of Rheumatic Fever.
- bacterial infection/inflammation of heart valves and inner lining
What should we avoid w/ Hemophilia clients unless absolutely necessary?
Normal Hgb is ---.
With SCD, Hbg is ---
Normal = 11 gm/dL
SCD = 2-5 gm/dL
S/S of Hemophilia
With Hemophilia, why avoid a Hot/Warm compress?
increases bleeding to the site!
S/S of DIC
Bleeding from openings in venipuncture site and surgical incision
Bleeding from umbilicus or trachea (newborn)
Bleeding evidence in GI
Organ dysfunction from infarction and ischemia
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
What is the key sign of Hemophilia?
- treat immediately
- rest, immobilize, elevate, supply ice
Treatment for Kawasaki Disease
High dose of IVIG and Salicylate therapy
How common is stroke w/ SCD children?
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
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
Sickle Cell Crisis is triggered by --- or --- and signs include --- and ---
depletion of folic acid
--- -- -- follows strep when it is not treated properly.
Rheumatic Heart Disease
Treatment for Endocarditis
Prophylaxis Antibiotics (Penicillin best)
- especially BEFORE dentistry