NUR 230 Exam 4 Pediatric Final Exam Study Guide
NUR 230 Exam 4 Pediatrics:
Hemoglobin: 1-6 yrs old- (9.5-14) 6-18 yrs old- (10-15.5)
Hematology:
Iron deficiency anemia: inadequate amount of iron, children 12-36 mo.
• Iron supplements: give on empty stomach-infants, no cow’s milk, give with citrus for better
absorption-older child, use a straw-can stain teeth, give to breast fed babies by 4 months.
• Black tarry stools from supplements= Normal!
• Encourage iron rich foods: green leafy, supplements, organ meats, rice cereal @ 6 months.
• S/S: tachycardia, may over over or underweight, pallor, murmur, FTT, fatigue. Assess for pica.
Sickle cell anemia: hereditary, autosomal recessive trait. Insufficient oxygen cause cells to sickle
shape & getting jammed causing an obstruction of RBCs (blow flow) causing pain. Effects the
spleen.
• COMPLICATIONS: CVA (stroke) & acute chest syndrome (like pneumonia)
Sickle cell crisis: acute exacerbations of the disease, types of crises based on frequency/severity.
Vaso-occlusive: painful episode, will see swelling in hands/feet
• Splenic sequestration: pooling of blood in the spleen.
• Aplastic: decreased RBC production
• Causes: infection, stress, trauma, dehydration—> IV FLUIDS**
• *Prevent infection with prophylactic antibiotics & vaccines: pneumococcal, influenza,
meningococcal*
• Tx: increase fluids, treat pain, monitor vitals, give oxygen, bed rest.
• **If pt has had pain med & still in pain or has headache- call Dr, could be a stroke**
, Hemophilia: deficiency of factor VIII (clotting factor) produced by the liver
S/S: prolonged bleeding, epistaxis (nose bleeds), @ risk for hemorrhage, bruising, hemarthrosis
(joint bleeding), hematuria
o Hemarthrosis & hematuria: corticosteroids o *Black tarry stools= not good-
BLEEDING*
• Tx: replace clotting factor, control bleeding (RICE), cold compress for joint pain/swelling*,
caution with NSAIDS due to bleeding risk.
o Suggest low contact sports such as swimming**
Oncology:
Leukemia: malignant disease of the bone marrow, lymphatic system
• S/S: anemia, infection, bleeding, fatigue, fever, easily bruising, pallor, joint pain, enlarged
spleen/liver.
• ALL (acute lymphocytic leukemia)- most common type of childhood cancer
• Tx: IV chemo—> **pt has a reaction- stop pump immediately, flush the line & call the Dr.* o
Bone marrow transplant possible if NOT reacting well to chemo.
o Decrease infection risks (private room, hand hygiene, no flowers, no sick visitors)
Neuroblastoma: most common type of cancer in infants, silent tumor. Firm, non-
tender, irregular mass on the abdomen- CROSSES MIDLINE*
• Tx: bone marrow aspiration, chemo, surgery
Osteosarcoma: most common bone cancer, (long bones-femur)- arises from osseous tissue.
• Common in male young adults/adolescents
• S/S: limp, pain @ site, may have palpable mass.
• Tx: limb salvage, leg amputation
NUR 230 Exam 4 Pediatrics:
Hemoglobin: 1-6 yrs old- (9.5-14) 6-18 yrs old- (10-15.5)
Hematology:
Iron deficiency anemia: inadequate amount of iron, children 12-36 mo.
• Iron supplements: give on empty stomach-infants, no cow’s milk, give with citrus for better
absorption-older child, use a straw-can stain teeth, give to breast fed babies by 4 months.
• Black tarry stools from supplements= Normal!
• Encourage iron rich foods: green leafy, supplements, organ meats, rice cereal @ 6 months.
• S/S: tachycardia, may over over or underweight, pallor, murmur, FTT, fatigue. Assess for pica.
Sickle cell anemia: hereditary, autosomal recessive trait. Insufficient oxygen cause cells to sickle
shape & getting jammed causing an obstruction of RBCs (blow flow) causing pain. Effects the
spleen.
• COMPLICATIONS: CVA (stroke) & acute chest syndrome (like pneumonia)
Sickle cell crisis: acute exacerbations of the disease, types of crises based on frequency/severity.
Vaso-occlusive: painful episode, will see swelling in hands/feet
• Splenic sequestration: pooling of blood in the spleen.
• Aplastic: decreased RBC production
• Causes: infection, stress, trauma, dehydration—> IV FLUIDS**
• *Prevent infection with prophylactic antibiotics & vaccines: pneumococcal, influenza,
meningococcal*
• Tx: increase fluids, treat pain, monitor vitals, give oxygen, bed rest.
• **If pt has had pain med & still in pain or has headache- call Dr, could be a stroke**
, Hemophilia: deficiency of factor VIII (clotting factor) produced by the liver
S/S: prolonged bleeding, epistaxis (nose bleeds), @ risk for hemorrhage, bruising, hemarthrosis
(joint bleeding), hematuria
o Hemarthrosis & hematuria: corticosteroids o *Black tarry stools= not good-
BLEEDING*
• Tx: replace clotting factor, control bleeding (RICE), cold compress for joint pain/swelling*,
caution with NSAIDS due to bleeding risk.
o Suggest low contact sports such as swimming**
Oncology:
Leukemia: malignant disease of the bone marrow, lymphatic system
• S/S: anemia, infection, bleeding, fatigue, fever, easily bruising, pallor, joint pain, enlarged
spleen/liver.
• ALL (acute lymphocytic leukemia)- most common type of childhood cancer
• Tx: IV chemo—> **pt has a reaction- stop pump immediately, flush the line & call the Dr.* o
Bone marrow transplant possible if NOT reacting well to chemo.
o Decrease infection risks (private room, hand hygiene, no flowers, no sick visitors)
Neuroblastoma: most common type of cancer in infants, silent tumor. Firm, non-
tender, irregular mass on the abdomen- CROSSES MIDLINE*
• Tx: bone marrow aspiration, chemo, surgery
Osteosarcoma: most common bone cancer, (long bones-femur)- arises from osseous tissue.
• Common in male young adults/adolescents
• S/S: limp, pain @ site, may have palpable mass.
• Tx: limb salvage, leg amputation
