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Questions and Answers
Iron-fortified formula is recommended for infants until what age?
Iron-fortified formula is recommended for infants until what age?
Carriers of the sickle cell trait:
Carriers of the sickle cell trait:
Which nursing intervention is appropriate for a child in sickle cell crisis?
Which nursing intervention is appropriate for a child in sickle cell crisis?
What is the primary treatment for thalassemia major?
What is the primary treatment for thalassemia major?
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Hemophilia is most commonly transmitted through:
Hemophilia is most commonly transmitted through:
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What are the primary sites of blood formation in the fetus during the last trimester of pregnancy?
What are the primary sites of blood formation in the fetus during the last trimester of pregnancy?
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Which component of blood is responsible for oxygen transport?
Which component of blood is responsible for oxygen transport?
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What is a possible consequence of hyperhemolytic crises in children?
What is a possible consequence of hyperhemolytic crises in children?
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What is the effect of erythropoietin on red blood cell production?
What is the effect of erythropoietin on red blood cell production?
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Which treatment option is specifically approved by the FDA for sickle cell disease?
Which treatment option is specifically approved by the FDA for sickle cell disease?
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What is the function of erythrocytes in the bloodstream?
What is the function of erythrocytes in the bloodstream?
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What happens to the white blood cell (WBC) levels in newborns within the first week of life?
What happens to the white blood cell (WBC) levels in newborns within the first week of life?
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What symptom is typically associated with thalassemia major?
What symptom is typically associated with thalassemia major?
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Which condition can result from inadequate dietary iron intake during critical growth periods in children?
Which condition can result from inadequate dietary iron intake during critical growth periods in children?
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Which system is involved in draining regions of the body to lymph nodes for immune response?
Which system is involved in draining regions of the body to lymph nodes for immune response?
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What is the primary purpose of monitoring sodium levels in children with sickle cell disease?
What is the primary purpose of monitoring sodium levels in children with sickle cell disease?
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What triggers the sickling of red blood cells in sickle cell disease?
What triggers the sickling of red blood cells in sickle cell disease?
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What is a goal of nursing care in managing complications of sickle cell disease?
What is a goal of nursing care in managing complications of sickle cell disease?
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What is a common manifestation seen in children suffering from long-standing anemia?
What is a common manifestation seen in children suffering from long-standing anemia?
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What is the recommended method for administering iron supplements to maximize absorption in infants?
What is the recommended method for administering iron supplements to maximize absorption in infants?
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What is a common clinical manifestation of Idiopathic Thrombocytopenic Purpura (ITP)?
What is a common clinical manifestation of Idiopathic Thrombocytopenic Purpura (ITP)?
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Which treatment is typically the first-line for children diagnosed with ITP?
Which treatment is typically the first-line for children diagnosed with ITP?
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Which of the following is a key feature of hemophilia management?
Which of the following is a key feature of hemophilia management?
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What is the primary risk concern in a child with hemophilia?
What is the primary risk concern in a child with hemophilia?
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In the context of Henoch-Schönlein purpura, which symptom is NOT typically observed?
In the context of Henoch-Schönlein purpura, which symptom is NOT typically observed?
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Study Notes
Hematological System
- The hematological system encompasses the blood and blood-forming organs, vital for body functions.
- Blood dyscrasias arise when blood components form improperly or blood values deviate from normal ranges.
- Blood cell formation (hematopoiesis) begins in the yolk sac around the second week of gestation.
- Fetal blood formation primarily occurs within the liver until the final trimester.
- During childhood, red blood cells (RBCs) develop in long bone marrow (e.g., tibia, femur).
- In adolescence, hematopoiesis takes place in the ribs, sternum, vertebrae, pelvis, skull, clavicle, and scapulae.
- Erythropoietin regulates RBC production.
- Blood consists of plasma and formed elements (erythrocytes, leukocytes, thrombocytes).
- Newborns exhibit high hemoglobin and RBC counts due to placental blood shift and low extracellular fluid.
- Newborn white blood cell (WBC) counts are initially high but decrease stably within a week.
- Vitamin K is administered immediately after birth due to low levels in newborns and its role in blood clotting.
- The lymphatic system (lymphocytes, vessels, nodes, spleen, tonsils, adenoids, thymus) destroys infectious agents and stimulates antibody production.
- Tonsils and adenoids are larger in preschool and school-aged children, part of the body's defense mechanisms.
- The thymus plays a crucial role in immune response development in infants.
- Preterm and term infants are vulnerable to infections due to immature T-cell activity.
Anemias
- Anemia results from diverse causes, negatively impacting oxygen transport.
- Hemoglobin levels below 8 g/dL increase cardiac output and redistribute blood flow to vital organs.
- Iron deficiency anemia is the most common nutritional deficiency in US children, prevalent during infancy and adolescence.
- This deficiency can arise from severe hemorrhage, insufficient iron absorption, excessive growth demands, or an inadequate diet (e.g., cow's milk, insufficient maternal intake).
- Manifestations include pallor, irritability, anorexia, decreased activity, and, in long-term cases, growth retardation and cognitive changes.
- Treatment involves oral iron supplements, often ferrous sulfate, taken between meals with vitamin C to enhance absorption.
- Liquid iron preparations should be taken through a straw to prevent tooth discoloration.
- Dietary iron-enriched foods are crucial for improving iron stores.
- Intramuscular or intravenous iron-dextran injections are reserved for treatment failures.
- Parent education about breastfeeding, iron-fortified formulas, introducing iron-enriched solids, recognizing stool changes, and avoiding iron supplementation with milk should be emphasized.
- Sickle cell anemia involves an inherited hemoglobin defect (hemoglobin S) leading to red blood cell sickling and clumping.
- This defect triggers a reduced blood oxygen capacity and can cause obstructions, leading to tissue damage (infarcts).
- Sickling episodes are triggered by dehydration, infection, stress, or exposure to cold.
Bleeding Disorders
- Hemophilia is a congenital bleeding disorder, predominantly affecting males.
- Hemophilia is a hereditary disease where blood clotting is not normal, which leads to spontaneous bleeding.
- Factor VIII (Hemophilia A) and Factor IX (Hemophilia B) deficiencies are common types.
- Symptoms include prolonged bleeding, hemarthrosis (bleeding into joints), hematomas, and spontaneous bleeding.
- Treatment involves replacing the missing clotting factor (e.g., recombinant factor VIII).
- Desmopressin (DDAVP) can increase factor VIII levels, while aminocaproic acid manages bleeding risk.
- Preventing injuries, choosing appropriate sports, utilizing RICE, considering medical alert bracelets, and incorporating home care programs (like support groups) is critical for support and managing the condition.
- Idiopathic thrombocytopenic purpura (ITP) is an acquired platelet disorder of unknown cause, potentially autoimmune in origin.
- ITP is characterized by easy bruising from slowed blood clotting, petechiae, purpura, bleeding from mucous membranes, and low platelet counts.
- Treatment involves identifying and managing intracranial bleeding, avoiding medications that thin the blood, limiting activity, and administering medications (steroids and IV gamma globulin).
- Henoch-Schönlein purpura is an autoimmune condition that inflammatory blood vessels, accompanied by multi-organ involvement, palpable purpura, ecchymosis, and abdominal pain. Treatment involves general supportive care, hydration, nutrition, and pain management.
Disorders of White Blood Cells
- Leukemia is a malignant disease affecting bone marrow and lymphatic system, characterized by uncontrolled immature WBC growth.
- Leukemia symptoms include fever, pallor, bleeding tendencies, pain, fatigue, abdominal pain, enlarged lymph nodes, skin discoloration, bruising, anorexia, vomiting, and respiratory distress.
- Diagnosis involves detailed history, bloodwork (leukemic blast cells), bone marrow biopsy, X-rays for bone changes, and spinal taps for central nervous system assessment.
- Nursing care for leukemia is multidisciplinary, including pediatricians, oncologists, nurses, and nutritionists, focusing on infection prevention (isolation, oral care), proper hydration, nutritional support (including TPN), observation for bleeding, and appropriate emotional support.
- Treatment involves chemotherapy, radiation therapy (with specific components like induction, prophylaxis, maintenance, reinduction), and, in some cases, bone marrow transplantation (autologous or allogeneic).
- Hodgkin's disease is a lymphoma primarily affecting lymph nodes; it's characterized by the presence of Reed-Sternberg cells.
- Hodgkin’s Disease presents with painless lumps, low-grade fever, night sweats, anorexia, weight loss, and malaise.
- Staging is crucial for treatment planning, with varying stages having different treatment approaches (often radiation and chemotherapy).
- Nursing care involves managing side effects, promoting coping mechanisms, educating families, and supporting emotional well-being.
Nursing Care of the Chronically Ill Child
- Chronic illnesses during childhood can affect growth and development, requiring specific programs fostering security and independence.
- Behavior problems related to chronic illness are lessened when children can convey concerns effectively to sensitive individuals.
- Maintaining a sense of normalcy through school participation is crucial for children with chronic illness, and therapeutic interventions to combat boredom and stress are beneficial.
- Home care ensures holistic support with an emphasis on the child's abilities, involving the child in decisions, promoting normalcy, and using respite care.
- Nursing care for dying children recognizes the grieving needs of the child and family, focusing on honesty, emotional support, and facilitating the grieving process with hospice involvement.
- Nurses must be aware of personal attitudes about life and death, and adapt their approach based on the child's stage of cognitive development.
- Strategies to support dying children and their families include active listening, providing privacy, offering therapeutic interventions, supplying information truthfully, and employing age-appropriate communication techniques.
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Description
Explore the essential components and functions of the hematological system. This quiz covers topics such as blood formation, blood dyscrasias, and the role of erythropoietin in regulating red blood cell production. Test your knowledge on how blood composition changes throughout life stages.
