The Child with a Condition of the Blood, Blood-forming Organs, or Lymphatic System
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Questions and Answers

Which blood component is primarily responsible for transporting oxygen and carbon dioxide?

  • Erythrocytes (correct)
  • Plasma
  • Leukocytes
  • Thrombocytes

    • What is the main role of leukocytes in the immune system?

  • Transporting nutrients
  • Fighting infection (correct)
  • Oxygen transport
  • Clot formation

    • Which of the following is a common manifestation of iron deficiency anemia?

  • Pallor (correct)
  • Cyanosis
  • Fever
  • Hypotension

    • What factor can trigger sickling in sickle cell disease?

    <p>Emotional stress</p> Signup and view all the answers

    What is the significance of the thymus gland in newborns?

    <p>Develops immune response</p> Signup and view all the answers

    Which treatment is commonly used for iron deficiency anemia?

    <p>Ferrous sulfate</p> Signup and view all the answers

    What condition is characterized by the clumping of sickle cells due to low oxygen levels?

    <p>Sickle cell disease</p> Signup and view all the answers

    Which of the following is a potential complication of sickle cell anemia?

    <p>Organ infarction</p> Signup and view all the answers

    Which anemia is noted as the most common nutritional deficiency in children in the US?

    <p>Iron deficiency anemia</p> Signup and view all the answers

    Which of the following is NOT a part of the lymphatic system?

    <p>Bone marrow</p> Signup and view all the answers

    What is a significant risk for preterm and term infants in relation to T-cell activity?

    <p>Higher infection rates</p> Signup and view all the answers

    What dietary sources are recommended for toddlers at risk of iron deficiency anemia?

    <p>Iron-rich solid foods</p> Signup and view all the answers

    Which symptom is commonly associated with anemia due to decreased hemoglobin levels?

    <p>Shortness of breath</p> Signup and view all the answers

    What can significantly interfere with the absorption of iron supplements?

    <p>Whole cow’s milk</p> Signup and view all the answers

    Which treatment strategy is essential for managing children with hemophilia during episodes of bleeding?

    <p>Using RICE (Rest, Ice, Compression, Elevation)</p> Signup and view all the answers

    What is a key clinical manifestation of Idiopathic Thrombocytopenic Purpura (ITP)?

    <p>Spontaneous bruising</p> Signup and view all the answers

    Which of the following is considered a life-threatening risk in children with hemophilia?

    <p>Intracranial bleeding</p> Signup and view all the answers

    Which medication is considered the first-line treatment for Idiopathic Thrombocytopenic Purpura (ITP)?

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

    What is crucial to maintain during the management of a child with ITP?

    <p>Monitoring for signs of bleeding</p> Signup and view all the answers

    Which dietary recommendation is appropriate for a child with hemophilia?

    <p>Increased intake of citrus fruits</p> Signup and view all the answers

    What can indicate the presence of Henoch-Schönlein purpura?

    <p>Petechiae and purpura</p> Signup and view all the answers

    What is a core aspect of managing children with bleeding disorders?

    <p>Encouraging independence and decision-making</p> Signup and view all the answers

    What risk factor is associated with the pathophysiology of Henoch-Schönlein purpura?

    <p>Respiratory illness</p> Signup and view all the answers

    Which of the following would NOT be a recommended activity for a child with hemophilia?

    <p>Contact sports</p> Signup and view all the answers

    How does leukemia primarily impact the body?

    <p>It inhibits the formation of RBCs from the marrow.</p> Signup and view all the answers

    What is NOT a characteristic of ITP?

    <p>High platelet count</p> Signup and view all the answers

    Which of the following is vital in differentiating bruises from ITP and signs of abuse?

    <p>Neurologic assessments</p> Signup and view all the answers

    What type of joint bleeding is especially common in children with hemophilia?

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

    What is one important aspect of nursing care for the dying child?

    <p>Providing support and facilitating the grieving process</p> Signup and view all the answers

    How should nurses approach a child's communication about death?

    <p>Use simple language and be honest</p> Signup and view all the answers

    What emotional reaction might siblings of a dying child experience?

    <p>Frustration and a sense of neglect</p> Signup and view all the answers

    Why is it essential for nurses to be aware of their own attitudes toward life and death?

    <p>It affects their nursing practice and empathetic response</p> Signup and view all the answers

    What is a common characteristic of children's understanding of death under the age of 5?

    <p>They may believe that death is reversible</p> Signup and view all the answers

    What might indicate that a terminally ill child is aware of their condition?

    <p>Changes in their drawings and play</p> Signup and view all the answers

    How should nurses respond when parents are visibly grieving in a child's room?

    <p>Listen and allow them to express their emotions</p> Signup and view all the answers

    What is a typical physical change an individual may exhibit as they approach death?

    <p>Cool and mottled skin</p> Signup and view all the answers

    What role does hospice care play in the context of terminal illness in children?

    <p>It provides support before and after death for the child and family</p> Signup and view all the answers

    Why is it important for children to express their feelings about death?

    <p>It helps them cope and process their emotions</p> Signup and view all the answers

    What is an essential nursing intervention for a child undergoing chemotherapy to prevent skin irritation?

    <p>Use PABA sunscreen before going outdoors.</p> Signup and view all the answers

    Which of the following actions helps support a child with cancer who is expressing anger?

    <p>Provide safe outlets for the safe direction of anger.</p> Signup and view all the answers

    What might be a common concern for a child undergoing cancer treatment related to growth?

    <p>Appearance of secondary sexual characteristics may be delayed.</p> Signup and view all the answers

    Why is education especially important for patients receiving care at home?

    <p>Most patients have to manage their own care after treatments.</p> Signup and view all the answers

    What should be done regarding immunizations for a child with leukemia who is not up to date?

    <p>Delay active immunization during chemotherapy.</p> Signup and view all the answers

    What is typically the first symptom seen in children with Hodgkin's disease?

    <p>Painless cervical neck lump.</p> Signup and view all the answers

    An adolescent with cancer who is refusing treatment should primarily be managed by:

    <p>Allowing them to have a say in their treatment options.</p> Signup and view all the answers

    What is a significant psychological benefit of school programs for hospitalized children?

    <p>They help maintain peer relationships and social skills.</p> Signup and view all the answers

    What is an effective method for managing behavior problems in chronically ill children?

    <p>Encouraging verbalization of specific concerns.</p> Signup and view all the answers

    Which service is designed to relieve parents of caregiving responsibilities temporarily?

    <p>Respite Care.</p> Signup and view all the answers

    How can home health care positively impact a child with developmental disabilities?

    <p>It emphasizes what the child can do.</p> Signup and view all the answers

    Which of the following symptoms can be associated with advanced cases of Hodgkin’s disease?

    <p>Night sweats and unexplained weight loss.</p> Signup and view all the answers

    What is an appropriate action when a child expresses reluctance to adhere to treatment protocols?

    <p>Take steps to understand their perspective and engage them.</p> Signup and view all the answers

    Which emotional response should nurses be prepared to support in children diagnosed with chronic illnesses?

    <p>Strong feelings of anger and frustration.</p> Signup and view all the answers

    At what stage of gestation does blood formation primarily occur in the yolk sac?

    <p>Around the second week</p> Signup and view all the answers

    Which organ is primarily responsible for blood formation in the fetus until the last trimester of pregnancy?

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

    What is the function of erythropoietin in the hematological system?

    <p>Regulates red blood cell production</p> Signup and view all the answers

    Why is vitamin K administered immediately after birth to newborns?

    <p>To aid in the development of blood clotting factors</p> Signup and view all the answers

    Which component of blood is responsible for transporting oxygen throughout the body?

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

    Which statement about white blood cell (WBC) levels in newborns is true?

    <p>WBC levels are stable immediately after birth.</p> Signup and view all the answers

    What does the lymphatic system primarily do?

    <p>Drains regions of the body to lymph nodes</p> Signup and view all the answers

    By what age does hematopoiesis mainly occur in the marrow of the ribs, sternum, and pelvis?

    <p>By adolescence</p> Signup and view all the answers

    Which of the following symptoms is NOT commonly associated with thalassemia major?

    <p>Frequent respiratory infections</p> Signup and view all the answers

    Which treatment is specifically aimed at reducing the iron overload in patients with thalassemia?

    <p>Chelating agents</p> Signup and view all the answers

    What is the primary function of hydroxyurea in sickle cell disease treatment?

    <p>Enhance fetal hemoglobin production</p> Signup and view all the answers

    What is a common consequence of hyperhemolytic crises in sickle cell disease?

    <p>Reduced spleen function</p> Signup and view all the answers

    What type of inheritance pattern is seen in beta-thalassemia minor?

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

    Which of the following vaccines is recommended for preventing infections in children with sickle cell disease?

    <p>Pneumococcal vaccine</p> Signup and view all the answers

    What is the typical clinical presentation of aplastic crises in children with sickle cell disease?

    <p>Severe anemia</p> Signup and view all the answers

    Which medication is used to relieve severe pain in children during a sickle cell crisis?

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

    Which of the following is a recommended nursing intervention for managing sickle cell crises?

    <p>Maintain venous thrombosis prophylaxis</p> Signup and view all the answers

    Which diagnostic method helps in distinguishing between sickle cell trait and sickle cell disease?

    <p>Hemoglobin electrophoresis</p> Signup and view all the answers

    In children with thalassemia major, which physical change is often observed as a result of bone marrow expansion?

    <p>Facial and skull contour changes</p> Signup and view all the answers

    Which of the following assessments is crucial for monitoring potential complications in a child undergoing frequent blood transfusions?

    <p>Temperature monitoring for infections</p> Signup and view all the answers

    What is the primary goal of screening for sickle cell disease in newborns?

    <p>To prevent complications of the disease</p> Signup and view all the answers

    What is considered a common manifestation of leukemia in children?

    <p>Skin has a lemon-yellow appearance</p> Signup and view all the answers

    What diagnostic procedure is commonly used to confirm leukemia?

    <p>Bone marrow biopsy</p> Signup and view all the answers

    Which symptom is most commonly associated with thrombocytopenia in leukemia patients?

    <p>Petechiae and ecchymosis</p> Signup and view all the answers

    What is a crucial nursing intervention for a child undergoing chemotherapy?

    <p>Obvious hydration to prevent kidney damage</p> Signup and view all the answers

    Which of the following is a primary treatment method for Hodgkin’s Disease?

    <p>Chemotherapy and radiation therapy</p> Signup and view all the answers

    Which of the following medications is commonly included in the COPP regimen for Hodgkin’s Disease?

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

    What is the main characteristic of Reed-Sternberg cells?

    <p>They are multinucleated giant cells</p> Signup and view all the answers

    What complication is commonly associated with neutropenia in a child receiving chemotherapy?

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

    In the context of leukemia treatment, why is nutritional support critical?

    <p>To combat the side effects of chemotherapy</p> Signup and view all the answers

    What is the preferred method for obtaining a bone marrow biopsy in children?

    <p>From the iliac crest as a common practice</p> Signup and view all the answers

    Which of the following describes the prognosis of Stage IV Hodgkin’s Disease?

    <p>Least favorable</p> Signup and view all the answers

    Which symptom would most likely indicate central nervous system involvement in leukemia?

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

    What is a common side effect of prednisone used in leukemia treatment?

    <p>Moon-shaped face appearance</p> Signup and view all the answers

    What is the recommendation for providing iron-fortified formula to infants?

    <p>Until they are 12 months old</p> Signup and view all the answers

    Which statement is true regarding individuals with sickle cell trait?

    <p>They carry hemoglobin S but show no symptoms</p> Signup and view all the answers

    What nursing intervention is appropriate for a child in sickle cell crisis?

    <p>Monitor response to analgesics</p> Signup and view all the answers

    Frequent blood transfusions in children with thalassemia major primarily maintain which level?

    <p>Hemoglobin levels above 9.5 g/dL</p> Signup and view all the answers

    What is a classic symptom of hemophilia?

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

    Which treatment option aims to replace missing clotting factors in hemophilia patients?

    <p>Recombinant antihemophilic factor</p> Signup and view all the answers

    Why should nursing staff delay heel sticks and IM injections for newborns with hemophilia?

    <p>To reduce blood loss risks</p> Signup and view all the answers

    What is the function of desmopressin acetate (DDAVP) in hemophilia treatment?

    <p>It promotes the production of factor VIII</p> Signup and view all the answers

    Which of the following is NOT a symptom associated with severe hemophilia?

    <p>Ineffective immune response</p> Signup and view all the answers

    When does spontaneous hematuria typically occur in hemophilia patients?

    <p>Without any apparent cause</p> Signup and view all the answers

    What percentage of children born to both parents who are carriers of sickle cell trait will inherit the disease?

    <p>25%</p> Signup and view all the answers

    What type of hemophilia is associated with Factor IX deficiency?

    <p>Hemophilia B</p> Signup and view all the answers

    When is cow's milk typically introduced into an infant's diet?

    <p>At 1 year</p> Signup and view all the answers

    Which of the following interventions should be avoided during a sickle cell crisis?

    <p>Applying ice to painful areas</p> Signup and view all the answers

    Study Notes

    Hematological System in Pediatrics

    • The hematological system comprises the blood and blood-forming organs, vital for all bodily functions.
    • Blood disorders (dyscrasias) occur when blood components form incorrectly or blood values deviate from normal ranges.
    • Blood cell formation (hematopoiesis) begins in the yolk sac during gestation.
    • Fetal blood formation is primarily in the liver until the last trimester.
    • During childhood, red blood cells (RBCs) form in the marrow of long bones.
    • During adolescence, hematopoiesis occurs in various bone marrow sites (ribs, sternum, vertebrae, pelvis, skull, clavicle, scapulae).
    • Erythropoietin regulates RBC production.
    • Blood components include plasma and formed elements: erythrocytes, leukocytes, thrombocytes.

    Blood Component Differences in Infancy

    • Newborns have high hemoglobin and RBC counts due to high erythropoietin levels, placental blood shift, and low extracellular fluid volume.
    • High white blood cell (WBC) count at birth decreases to a stable level by one week.
    • Newborns have low vitamin K levels, requiring immediate administration for proper blood clotting factor development.

    Lymphatic System in Pediatrics

    • The lymphatic system includes lymphocytes, vessels, nodes, spleen, tonsils, adenoids, and thymus.
    • It drains bodily regions to lymph nodes, where pathogens are destroyed and antibodies produced.
    • Enlarged tonsils and adenoids in preschool and school-aged children are normal defense mechanisms.
    • The thymus, crucial for newborn immune response development, is essential for proper immunity
    • Preterm and term infants are at higher risk for infections due to reduced T-cell activity.

    Anemia in Children

    • Anemia arises from various causes and reduces the blood's oxygen-carrying capacity.
    • Hemoglobin levels below 8 g/dL increase cardiac output and redirect blood to vital organs..
    • Common manifestations include pallor, weakness, tachycardia, and shortness of breath; and potentially, congestive heart failure.

    Iron Deficiency Anemia

    • The most common nutritional deficiency in US children, particularly during rapid growth spurts (infancy and adolescence).
    • Causes include severe hemorrhage, impaired absorption, excessive growth demands, and inadequate diet.
    • Feeding whole cow’s milk can cause GI bleeding, and maternal iron deficiency can contribute.
    • Manifestations include pallor, irritability, anorexia, decreased activity, and, with long-standing anemia, growth retardation and cognitive changes.
    • Treatment involves iron supplements (usually ferrous sulfate), taken between meals with vitamin C for absorption.
    • Liquid iron should be administered via a straw to prevent tooth staining.
    • Breastfeeding and iron-fortified formulas are crucial.
    • Treatment may require intramuscular or intravenous iron-dextran for non-responders.
    • Parents need education on diet, iron supplementation, and follow-up care.

    Sickle Cell Anemia

    • An inherited hemoglobin disorder, mainly affecting African Americans (1 in 365 births), with Mediterranean descent carriers also present.
    • Decreased blood oxygen triggers sickling (clumping) of red blood cells.
    • Causes include dehydration, infection, stress, or cold exposure.
    • These abnormal cells (hemoglobin S) cause slowed blood flow & clots (thrombosis), leading to tissue damage (infarcts)—commonly in spleen; but potentially in other organs.
    • Acute pain in affected regions.
    • Sickle cell trait does not lead to the disease; but genetic counseling is recommended.
    • Inheritance involves a one-in-four chance of an offspring inheriting the disease if both parents are carriers.
    • Types of crises include: vaso-occlusive, splenic sequestration, aplastic, and hyperhemolytic.
    • Treatment involves supportive care (hydration, rest, pain management, blood transfusions), and hydroxyurea (HU).
    • Nursing care includes preventing dehydration, infection, and crises.

    Thalassemia

    • Hereditary disorders impairing adult hemoglobin production, leading to abnormal, fragile RBCs.
    • Body attempts to increase fetal hemoglobin by compensating.
    • Types include α- and β-thalassemia.
    • β-thalassemia is a common form.
    • Thalassemia minor (β-thalassemia trait) is a milder form with a heterozygous inheritance.
    • Thalassemia major (Cooley anemia) is a severe form with a homozygous inheritance.
    • Symptoms include pallor, hypoxia, poor appetite, fever, muddy bronze jaundice (from tissue iron deposition), enlarged liver/spleen, and skeletal deformities.
    • Diagnosis involves family history, hematologic tests, x-rays, and hemoglobin electrophoresis.
    • Treatment methods include blood transfusions to maintain hemoglobin levels, chelating medications (deferasirox, deferiprone), splenectomy, and potential hematopoietic stem cell transplantation.

    Bleeding Disorders

    • Hemophilia: Inherited blood clotting disorders (Factor VIII or IX deficiency) characterized by prolonged bleeding & hemarthrosis (bleeding into joints).
    • Treatment and Nursing: Factor replacement therapy (recombinant factors or DDAVP). Minimize injuries and ensure adequate rest.
    • Idiopathic Thrombocytopenic Purpura (ITP): Acquired platelet disorder, the cause is unknown but suspected to be an autoimmune response to a virus.
    • Treatment: Recognizing possible intracranial bleeding is essential in treatment. This includes neurologic assessments, distinguishing bruises from abuse, restricting activities during the acute stage, and avoiding any medications that affect platelets.
    • Henoch-Schönlein Purpura (HSP): Multi-organ autoimmune inflammation of blood vessels.
    • Treatment: General supportive care, hydration, nutrition, and pain control.

    Disorders of White Blood Cells

    • Leukemia: Malignant bone marrow and lymphatic system cancers, characterized by uncontrolled growth of immature white blood cells.
    • Treatment options include a multidisciplinary team, chemotherapy, supportive care, and hematopoietic stem cell transplantation (autologous or allogeneic).
    • Hodgkin’s Disease: Lymphatic system malignancy, characterized by unique Reed-Sternberg cells.
    • Treatment involves radiation and chemotherapy regimens (like COPP).
    • Nursing care focuses on symptom management, supporting growth and development, protecting the skin from radiation, and providing emotional support.

    Nursing Care of the Chronically Ill Child

    • Chronic illness can impact growth and development.
    • Providing a supportive environment is vital.
    • Behavior problems lessen when children can express concerns.
    • Hospital school programs help maintain normalcy.
    • Recreational therapy and respite care can be beneficial.
    • Home healthcare supports the child and family holistically.
    • Maintaining normality, inclusion, and control are essential in treatment.

    Nursing Care of the Dying Child

    • Nurses must understand grieving and cultural views.
    • Hospice care can provide crucial support.
    • Honesty, emotional support, and allowing child control are important components.
    • Children express grief and needs symbolically.
    • Nurses must acknowledge the grieving process of the family as well as the child.

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    Description

    Explore the key components and functions of the hematological system in pediatrics. Understand blood disorders, hematopoiesis across different life stages, and the differences in blood components in infancy. This quiz will guide you through the intricacies of pediatric hematology.

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