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NURSING CARE OF THE CHILD WITH A HEMATOLOGIC ALTERATION

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NURSING CARE OF THE CHILD WITH A HEMATOLOGIC ALTERATION Disorders of the red blood cells RBCs are pale and smaller Iron Deficiency Anemia Most common anemia caused by ... – PowerPoint PPT presentation

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Title: NURSING CARE OF THE CHILD WITH A HEMATOLOGIC ALTERATION


1
NURSING CARE OF THE CHILD WITH A HEMATOLOGIC
ALTERATION
2
Disorders of the red blood cells
  • RBCs are pale and smaller
  • Iron Deficiency Anemia
  • Most common anemia caused by improper iron intake
  • Giving cows milk instead of baby formula is main
    culprit during the first year
  • Adolescent girls are at risk because of
    menstruation
  • Causes poor growth, poor test scores later
  • Treatment
  • Ferrous Sulfate for two months
  • Restoration takes three months
  • Retic count will increase 7-10 days after
    starting therapy
  • Education
  • Give between meals for better absorption
  • Vit C increases absorption
  • Milk and tea with meals reduces absorption

3
Disorders of the red blood cells
  • Macrocytic Anemias
  • RBCs are larger than usual
  • Megaloblastic Anemias
  • Folic Acid Deficiency
  • Causes in children
  • Low birth weight
  • Intake of powdered or goats milk
  • Defective absorption
  • S/S
  • Poor weight gain
  • Chronic diarrhea
  • Management
  • Folic acid

4
  • Megaloblastic Anemias
  • Pernicious Anemia
  • Causes
  • Lack of intrinsic factor, must be deficient 2
    years for symptoms to develop
  • Management
  • Vitamin B12 1mg daily x 1-2 weeks, then once
    weekly until HH are normal, then monthly for
    life
  • Hemolytic Anemias
  • Sickle Cell Disease
  • Autosomal recessive, sickle shaped RBCs
  • Asymptomatic in infancy prior to 5-6 months
  • Clinical course characterized by episodic crises
  • Management
  • Pain relief, hydration, oxygenation

5
DISORDERS OF BLOOD COAGULATION
  • Hemophilias
  • Hemophilia A (Factor VIII deficiency)
  • Sex-linked recessive
  • S/S
  • Soft tissue bleeding and bleeding into joints
  • Management
  • Administration of factor VIII
  • Von Willebrands disease
  • Autosomal dominant
  • Factor VIII defect, inability of platelets to
    aggregate, and inability of blood vessels to
    constrict

6
  • Hemophilias continued
  • S/S
  • Bleeding, esp, from m.m.
  • Management
  • Factor VIII replenishment or DDAVP
  • Christmas disease (Hemophilia B, Factor IX
    deficiency)
  • Sex-linked recessive
  • Treated with factor IX
  • Hemophilia C (Factor XI deficiency)
  • Autosomal recessive
  • Symptoms are mild when compared to other types

7
Immune Thrombocytopenia Purpura
  • Acquired disorder characterized by low platelet
    count
  • Etiology
  • Can be drug-induced or follows a febrile illness
  • S/S
  • Bruising and petechiae
  • Therapeutic Management
  • Usually self-limiting but may require steroids,
    IV immunoglobulin, or splenectomy
  • Nursing considerations
  • No IM injections
  • No rectal temps
  • Avoid meds that kill/interfere with platelet
    production

8
Aplastic Anemia
  • Bone marrow ceases production of all cells
  • S/S
  • Petechiae, pallor, fatigue, bruising
  • Etiology
  • Congenital, exposure to drugs/chemicals,
    idiopathic
  • Therapeutic Management
  • Transfusions, stem cell transplant, chemotherapy
  • Nursing Considerations
  • Low-platelet considerations plus reverse
    isolation
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