Week 5: Hematological and Immunological Disorders Flashcards
(38 cards)
Assessment for hematologic and immunologic dysfunction
CBC, Hx, Physical, comments by parents on energy, food diary, frequent infections, bleeding
Anemia
RBC disorder. Decrease in RBC or Hgb.
How might we treat underlying cause of anemia?
Tranfusions after hemorrhage, nutritional intervention
Supportive care for anemia?
IV fluids, oxygen, bed rest
Why are adolescents at risk for iron deficiency anemia?
Rapid growth and poor eating habits
Nursing management of anemia
Lab test, oxygen demand decrease, prevent complications, support and educate the family
How should you address cow milk in diet?
Avoid until 12 months and limit to 600ml daily
Pathophysiology of sickle cell anemia
Obstruction of sickled RBc, vascular inflammation, increased RBC destruction
Sickle cell anemia
Called hemoglobinopathies. Normal adult Hgb is replaced by sickle cell hub. Most commonly affects black people
What does acute form of leukaemia cause?
Low leukocyte count
Abnormal adhesion + inflammatory process
= vasoconstriction
Absence of blood flow to tissues causing local hypoxia, tissue ischemia, and infarction
What is used to diagnose leukaemia?
Peripheral blood smear looking for immature leukocytes and frequently low blood counts
A patient presents with periods of exacerbation of the following symptoms Vaso-occluisve crisis, stroke, chest syndrome, acute splenic sequestration, hyperhemolytic, infection
Sickel cell anemia
How would you manage a patient with sickle cell anemia?
rest, hydration, oxygen, electrolyte replacement, pain management, blood transfusions, antibiotics, education and support
Neoplastic disorders are…
Leading cause of death from disease in children past infancy. Almostt half of all childhood cancers involve blood or blood-forming organs
Pathophysiology of leukaemia?
Unrestricted proliferation of immature WBC in blood forming tissues of the body. Mostly impacts liver and spleen.
Leukaemia
broad group of malignant disease of bone marrow and lymphatic system. Complex disease with varying hetergeneity.
Symptoms of leukaemia?
Fever, fatigue, swollen lymph nodes, frequent infections, unexplained weight loss, bleeding, swollen gums, enlarged spleen, slow to heal from abrasions
Intensification
Consolidation/post remission. Erradicate residual leukaemia cells and prevent resistant leukaemia clones
When do you use a lumbar puncture in leukaemia?
To evaluate CNS involvement in the disease
What do we think if there is a relapse after transplant?
Dismal prognosis
What factors are used to determine the prognosis following a leukaemia diagnosis?
Initial WBC count, age, type of cells involved, cytogenetics, immunophenotype, response to induction therapy
Non-Hodkins lymphoma
More in kids under 14
Therapuetic management of leukaemia?
chemo, cranial irradiation, transfusions, normally 4 phases of treatment
