Hematology/Cancer Nur 311 Exam 2
How do you calculate ANC ANS; Bands% + Segs% (WBC)
Example: Bands 7%, Segs 2%, WBC 2,000
(0.09*2,000)=180
ANC is 180 and patient needs to be put on neutropenic precautions r/t ANC below 500/mm3.
what food is the usual suspect for causing anemia in a child? ANS; Milk
what temperature is considered a medical emergency for neutropenia ANS; Temperature > 100 is
considered a medical emergency!!
Diet For Iron deficiency anemia ANS; dried fruit, eggs, liver, dark leafy vegetables, whole grains, raisins.
Eggs and PB have to be over a year to have, EVEN THO IS CORRECT CAN'T HAVE YET
How is oral iron best absorbed ANS; in an acidic environment
When should oral iron be admin ANS; Between meals or with ascorbic acid to facilitate absorption.
side effects of oral iron ANS; Heartburn, constipation, diarrhea. Will stain teeth and turn stools black.
Needs to be stored in a safe place
Nursing teaching about oral iron ANS; Give with straw or back in the mouth past the teeth
Rinse mouth/ brush teeth after administration.
Teach parents; measure accurately, increase fluids and fiber in diet.
Treatment for Iron overdose ANS; Deferoxamine.
,Severe poisonings will require IV (intravenous) chelation therapy. The patient receives a series of IVs
containing deferoxamine mesylate (Desferal), a chemical that binds to iron in the blood and is then
excreted in urine.
When should someone be placed on neutropenic precaution? ANS; When their ANC count is below 500
Nutrition management of IDA for infant ANS; -Breast milk for 1st 6 months
-At age 6 months iron fortified formula and cereal
-No more than 32 oz of milk before a year and 24 oz after 1 year.
-Shouldn't have a bottle after 12 months
what is the leading cause of death in young children with sickle cell disease ANS; bacterial infection
sickle cell disease is seen most in what type of people ANS; African Americans
When you think of sickle cell disease what should you think of first ANS; HYDRATION!!! HYDRATION!!!!
HYDRATION!!!
Genomics of sickle cell ANS; Autosomal recessive hemolytic anemia. When you have greater than 50%
HGB S you have SCA
what is the problem with RBCs with Hgb S ANS; They obstruct Capillary blood flow
Sickle Cell Crises ANS; severe, painful episodes of sickle cell anemia due to clumping and occlusion of
blood vessels. Anything that increases the body's need for oxygen or alters transport of oxygen ex:
Exercise, Stress
,Vaso-occlusive (VOC) thrombotic ANS; -Most common crisis with SCA
-Very painful
-Keep hydrated
Signs—fever, pain, tissue engorgement
What kind of therapy should you not use for sickle cell anemia ANS; Do not use cold therapy for SCA. NO
icepacks. Can use heat
What is a common surgical procedure done for patients with SCA ANS; Splenectomy. Loose spleen r/t
don't want spleen to rupture
Crisis Management/Nursing Considerations SCA ANS; Maintain Hydration-IV Therapy(PRIORITY OVERO2)
Maintain Oxygenation
Pain management
Support for the Child & Family
What type of Hgb are we wanting to increase for a patient with SCA ANS; Hgb F production
what is the problem with Cooley Anemia ANS; Alpha or beta-globulin chain in Hgb synthesis is reduced
or entirely absent.- Leads to chronic Hypoxia
Genomics of Cooley Anemia ANS; Autosomal recessive. Both parents must be carriers to have offspring
with disease
what is a major concern with Cooley Anemia ANS; Chronic Hypoxia
What does a child with Cooley Anemia look like ANS; Bronze skin tone from hemosidorosis.
, Growth retardation and delayed puberty
Flat nasal bridge, maxilla hyperplasia, frontal bossing
How is Cooley Anemia treated ANS; Blood transfusion to maintain normal Hgb levels.
Monitor chelation Therapy
*Excreted via the kidneys so ADEQUATE HYDRATION is vital
How do you detect SCIDS in a child ANS; Early frequent infections
Failure to thrive
Chronic diarrhea
Persistent thrush
Adventitious sounds related to pneumonia
Lab findings of very low levels of immunoglobulin's
Graft versus host reaction to any foreign tissue
Medical/ Nursing Management SCID ANS; IV immunoglobulin
Sterile environment
*Bone marrow transplant* ANS; only hope for survival
Prevent exposure to infections
Support & educate family
Can a mom with HIV Breastfeed? ANS; NO!!! Can transmit the virus. Vertical transmission
How do we test for HIV in children ANS; -P24 Antigen*
-Polymerase chain reaction (PCR)- detection of proviral DNA, 95% Infants over 1 month of age.
How do you calculate ANC ANS; Bands% + Segs% (WBC)
Example: Bands 7%, Segs 2%, WBC 2,000
(0.09*2,000)=180
ANC is 180 and patient needs to be put on neutropenic precautions r/t ANC below 500/mm3.
what food is the usual suspect for causing anemia in a child? ANS; Milk
what temperature is considered a medical emergency for neutropenia ANS; Temperature > 100 is
considered a medical emergency!!
Diet For Iron deficiency anemia ANS; dried fruit, eggs, liver, dark leafy vegetables, whole grains, raisins.
Eggs and PB have to be over a year to have, EVEN THO IS CORRECT CAN'T HAVE YET
How is oral iron best absorbed ANS; in an acidic environment
When should oral iron be admin ANS; Between meals or with ascorbic acid to facilitate absorption.
side effects of oral iron ANS; Heartburn, constipation, diarrhea. Will stain teeth and turn stools black.
Needs to be stored in a safe place
Nursing teaching about oral iron ANS; Give with straw or back in the mouth past the teeth
Rinse mouth/ brush teeth after administration.
Teach parents; measure accurately, increase fluids and fiber in diet.
Treatment for Iron overdose ANS; Deferoxamine.
,Severe poisonings will require IV (intravenous) chelation therapy. The patient receives a series of IVs
containing deferoxamine mesylate (Desferal), a chemical that binds to iron in the blood and is then
excreted in urine.
When should someone be placed on neutropenic precaution? ANS; When their ANC count is below 500
Nutrition management of IDA for infant ANS; -Breast milk for 1st 6 months
-At age 6 months iron fortified formula and cereal
-No more than 32 oz of milk before a year and 24 oz after 1 year.
-Shouldn't have a bottle after 12 months
what is the leading cause of death in young children with sickle cell disease ANS; bacterial infection
sickle cell disease is seen most in what type of people ANS; African Americans
When you think of sickle cell disease what should you think of first ANS; HYDRATION!!! HYDRATION!!!!
HYDRATION!!!
Genomics of sickle cell ANS; Autosomal recessive hemolytic anemia. When you have greater than 50%
HGB S you have SCA
what is the problem with RBCs with Hgb S ANS; They obstruct Capillary blood flow
Sickle Cell Crises ANS; severe, painful episodes of sickle cell anemia due to clumping and occlusion of
blood vessels. Anything that increases the body's need for oxygen or alters transport of oxygen ex:
Exercise, Stress
,Vaso-occlusive (VOC) thrombotic ANS; -Most common crisis with SCA
-Very painful
-Keep hydrated
Signs—fever, pain, tissue engorgement
What kind of therapy should you not use for sickle cell anemia ANS; Do not use cold therapy for SCA. NO
icepacks. Can use heat
What is a common surgical procedure done for patients with SCA ANS; Splenectomy. Loose spleen r/t
don't want spleen to rupture
Crisis Management/Nursing Considerations SCA ANS; Maintain Hydration-IV Therapy(PRIORITY OVERO2)
Maintain Oxygenation
Pain management
Support for the Child & Family
What type of Hgb are we wanting to increase for a patient with SCA ANS; Hgb F production
what is the problem with Cooley Anemia ANS; Alpha or beta-globulin chain in Hgb synthesis is reduced
or entirely absent.- Leads to chronic Hypoxia
Genomics of Cooley Anemia ANS; Autosomal recessive. Both parents must be carriers to have offspring
with disease
what is a major concern with Cooley Anemia ANS; Chronic Hypoxia
What does a child with Cooley Anemia look like ANS; Bronze skin tone from hemosidorosis.
, Growth retardation and delayed puberty
Flat nasal bridge, maxilla hyperplasia, frontal bossing
How is Cooley Anemia treated ANS; Blood transfusion to maintain normal Hgb levels.
Monitor chelation Therapy
*Excreted via the kidneys so ADEQUATE HYDRATION is vital
How do you detect SCIDS in a child ANS; Early frequent infections
Failure to thrive
Chronic diarrhea
Persistent thrush
Adventitious sounds related to pneumonia
Lab findings of very low levels of immunoglobulin's
Graft versus host reaction to any foreign tissue
Medical/ Nursing Management SCID ANS; IV immunoglobulin
Sterile environment
*Bone marrow transplant* ANS; only hope for survival
Prevent exposure to infections
Support & educate family
Can a mom with HIV Breastfeed? ANS; NO!!! Can transmit the virus. Vertical transmission
How do we test for HIV in children ANS; -P24 Antigen*
-Polymerase chain reaction (PCR)- detection of proviral DNA, 95% Infants over 1 month of age.
