Hematologic Disorders in Children
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Questions and Answers

What is the purpose of bone marrow aspiration in children?

  • To treat blood disorders
  • To determine the type and quantity of cells being produced (correct)
  • To remove foreign matter from the blood
  • To diagnose tissue hypoxia

    • What stimulates the formation of red blood cells in the bone marrow?

  • Blood transfusion
  • Bone marrow aspiration
  • Erythropoietin (correct)
  • Tissue hypoxia

    • Why is the sternum not typically used as a bone marrow aspiration site in children?

  • It is more painful for children
  • It is less effective for diagnosis
  • It is too difficult to access
  • It is more frightening for children (correct)

    • What is washed RBCs used for in blood transfusions?

    <p>To remove foreign matter from the blood to reduce the risk of an antagonistic reaction</p> Signup and view all the answers

    What is the primary goal of hematopoietic stem cell transplantation?

    <p>To reestablish marrow function in a child with deficient or nonfunctioning bone marrow</p> Signup and view all the answers

    What is the first step in assessing children with hematologic disorders?

    <p>Complete history, including family history</p> Signup and view all the answers

    What is the role of kidneys in the production of red blood cells?

    <p>To produce erythropoietin, a hormone that stimulates red blood cell production</p> Signup and view all the answers

    What is a common symptom of anemia?

    <p>All of the above</p> Signup and view all the answers

    What is a nursing diagnosis related to anemia?

    <p>Knowledge deficit related to cause of illness</p> Signup and view all the answers

    What is the result of a reduced number of RBCs and/or hemoglobin concentration?

    <p>A reduction in the oxygen available to the tissues</p> Signup and view all the answers

    What is a diagnostic test for anemia?

    <p>All of the above</p> Signup and view all the answers

    What is a nursing intervention for anemia?

    <p>All of the above</p> Signup and view all the answers

    What is the primary cause of acute diarrhea?

    <p>Infection</p> Signup and view all the answers

    What is the main function of the digestive system?

    <p>To prepare foods for absorption</p> Signup and view all the answers

    At what age is the stomach capacity decreased in infants?

    <p>At birth</p> Signup and view all the answers

    What is the result of a failure of the embryonic structures of the face to unite?

    <p>Both cleft lip and palate</p> Signup and view all the answers

    What is the primary concern for the child with cleft lip and palate?

    <p>Both nutritional and oxygenation needs</p> Signup and view all the answers

    What is the primary goal of nursing intervention for the child with esophageal atresia?

    <p>Prevention of aspiration</p> Signup and view all the answers

    What is the age at which the cleft palate repair is usually performed?

    <p>18 months</p> Signup and view all the answers

    What is the congenital defect in which the diaphragm forms with an opening that allows abdominal organs to protrude into the chest?

    <p>Diaphragmatic hernia</p> Signup and view all the answers

    What is the primary goal of nursing intervention for the child with gastroesophageal reflux?

    <p>Support of upright positioning</p> Signup and view all the answers

    What is the most common type of hernia in males?

    <p>Inguinal hernia</p> Signup and view all the answers

    Study Notes

    Hematopoietic Stem Cell Transplantation

    • Hematopoietic stem cell transplantation is the intravenous infusion of stem cells from a compatible donor to reestablish marrow function in a child with deficient or nonfunctioning bone marrow.
    • Sources of stem cells include bone marrow obtained by marrow aspiration, peripheral blood, or umbilical cord blood.
    • Goal is to reestablish marrow function and treat hematologic disorders.

    Hematologic Disorders

    • Assessment: skin pallor, petechiae, bruising, lethargy, frequent infections, bleeding that is difficult to control, and diagnostic tests (CBC, iron, coagulation, and immune system status).
    • Nursing diagnoses: knowledge deficit, altered nutrition, anxiety, pain, and family coping.
    • Interventions: individual distraction techniques, blood sampling, blood or marrow transfusion, education on nutrition, pain management, and family support.

    Anemias

    • Definition: a condition where the number of RBCs and/or hemoglobin concentration is reduced below normal level.
    • Causes: reduced oxygen carrying capacity, tissue hypoxia, and diminished oxygen available to tissues.
    • Formation: RBCs are formed in the bone marrow under the stimulation of erythropoietin, a hormone formed by the kidneys.

    Bone Marrow Aspiration and Biopsy

    • Uses: determines the type and quantity of cells produced in the bone marrow.
    • Sites: iliac crests or spines in children (rather than the sternum, which is commonly used in adults).

    Blood Transfusion

    • Types: whole blood, packed RBCs, washed RBCs, plasma, plasma factors, platelets, WBCs, and albumin.
    • Uses: treats blood disorders and may include transfusions of blood or its products.

    Digestive System

    • Main function: prepares foods for absorption through mechanical and chemical breakdown.
    • Anatomy: mouth, pharynx, stomach, small intestines, liver, gallbladder, pancreas, and large intestine.
    • Physiology: peristalsis, rhythmic waves of muscular contraction, and mechanical functions of digestion immature at birth.

    Cleft Lip and Cleft Palate

    • Definition: a congenital defect resulting from failure of embryonic structures of the face to unite.
    • Incidence: 1 in 1000 births, commonly associated with chromosomal abnormalities.
    • Effects: interferes with oxygenation and nutritional needs, hampers normal process of children with parents bonding.

    Esophageal Atresia and Tracheoesophageal Fistula

    • Definition: congenital defects, upper segment of the esophagus ends in a blind pouch, and defect in which embryonic structures fail to divide into a separate esophagus and trachea.
    • Assessment: copious oral and nasal secretions, choking, coughing, and difficulty suctioning or gavage.
    • Interventions: prevention of aspiration, drainage tube, esophageal atresia end-to-end anastomosis, and feeding tube insertion through gastrostomy.

    Diaphragmatic Hernia

    • Definition: congenital defect, diaphragm forms between the thoracic and abdominal cavities, leaving an opening through which the esophagus and great vessels pass.
    • Effects: abdominal protrusion through the chest, compression of lungs, and reflux of stomach contents.
    • Therapeutic management: surgery, as soon as diagnosis is made.

    Gastroesophageal Reflux (GER)

    • Definition: backflow of gastric contents into the esophagus due to relaxation or incompetence of the lower esophageal or cardiac sphincter.
    • Association: hiatal (diaphragmatic) hernia.
    • Interventions: surgical repair, upright position, and conservative management.

    Inguinal and Femoral Hernia

    • Definition: protrusion of peritoneum through the abdominal wall in the inguinal canal (inguinal hernia) and femoral canal (femoral hernia).
    • Interventions: place client in head-elevated position following feedings and at night, and surgical repair.

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    Description

    Assess your knowledge of hematologic disorders in children, including their formation, diagnosis, and evaluation. Learn about the role of erythropoietin and the importance of family history in diagnosis.

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