, lOMoAR cPSD| 64639315
Hem/Onc/Grief and loss
EXAM 4 Review
Iron deficiency Anemia:
• Etiology/Diagnostics- inadequate amount of iron, children 12-36 months at risk
• S/S- tachycardia o Can be under weight or overweight
• Treatment- Iron rich foods (green leafy), supplements, dietary supplements, organ
meats, rice cereal at 6 months,
• Teaching- No cow’s milk until the baby is 1 years old o NO iron supplements with
milk, give on empty stomach acid makes it absorb better* o Liquid supplement can stain teach,
use straw or regular iron supplement capsule/pill o Black tarry green stools
o Keep away from children, never keep more than a month supply at home o
Infants 30 mins before on empty, older child with something citric for the acid* o
Dietary counseling
Sickle Cell Anemia: Prevent Dehydration
• Etiology/Diagnostics: Hereditary, Autosomal recessive trait. Cells are sickle shaped.
Repetitive decrease in 02 cell walls become rigid. Cells are getting jammed, causing an
obstruction of RBC’s, resulting in PAIN. The normal HGB is replaced with abnormal HGB.
Effects the spleen.
o Organ that’s mostly effected is the spleen* o Newborn Screening in the US
• S/S- o Vascular inflammation
o Pain-> severe abdominal pain or chest. Mid to severe from 1 min-days -> crisis o
Stroke -> Severe unrelieved headache** o Painful Swelling: hands, feet, joint pain
o Headache. Doesn’t go away with meds? Possible CVA. EMERGENCY* o One
CVA? R/F another** (stroke) o Visual disturbances o Obstructive jaundice o Fever 101.3
or higher o Severe hypoxia
VASOCCLUSIVE Crisis: Acute chest syndrome: mimics pneumonia “painful episode”
• Splenic Sequestration: Pooling of blood in the spleen o Caused: Infection, stress,
dehydration* USE IV FLUIDS***, trauma
• Treatment- o DON’T over oxygenate
o Heat
o Prophylactic antibiotics: R/F infection* Preventing Infection*
, lOMoAR cPSD| 64639315
Vaccines, Antibiotics (PCN) o If they’ve had a stroke, every 3-4 weeks for
transfusions* to prevent CVA o Decrease 02 demands
o Oral/IV hydration, Oral at home to prevent hospitalization o Splenectomy
(severe)
o Stem cell Transplant: considered curative (severe)
o Rest
o Control Pain: Morphine o Electrolyte replacement Teaching:
o Prevent hydration o Rest
o Improve oxygen but don’t over oxygenate o Educate importance of vaccines o
Know s/s of a stroke o Child is normal just gets sicker easier
Hemophilia: Missing Clotting Factor
• Etiology/Diagnostics: Deficiency of factor VIII, produced by the liver, bleeding
disorder Education: Parents -> genetic counseling
• S/S:
o PROLONGED bleeding, kid will bleed longer than other kids, gums, cuts,
injections o Hemorrhage: At higher risk
o Bruising
o Hemarthrosis: blood in joints (knees, elbows, ankles) o Spontaneous Hematuria:
dark urine, blood
o Hematomas -> pain, swelling, limited motion
o Headache
o Slurred Speech o Loss of Consciousness o Black Tarry Stools= Bleed o Vomiting
coffee ground emesis o Bleeding gyms with teeth brushing
• Treatment: NO cure; lifelong o Replace VIII factor:
o Prevent bleeding: No IM vaccines, try subQ or less invasive first o Medications
Steroids
NSAIDS
DDAVP o Wear helmets
o Safety, protective equipment o Regular Exercise and Physical Therapy o Go to
doctor for sprains o Control Bleeding
R: Rest
I: ICE
C: Compress (cold)**
E: Elevate
Oncology
Pediatric Oncology
Hem/Onc/Grief and loss
EXAM 4 Review
Iron deficiency Anemia:
• Etiology/Diagnostics- inadequate amount of iron, children 12-36 months at risk
• S/S- tachycardia o Can be under weight or overweight
• Treatment- Iron rich foods (green leafy), supplements, dietary supplements, organ
meats, rice cereal at 6 months,
• Teaching- No cow’s milk until the baby is 1 years old o NO iron supplements with
milk, give on empty stomach acid makes it absorb better* o Liquid supplement can stain teach,
use straw or regular iron supplement capsule/pill o Black tarry green stools
o Keep away from children, never keep more than a month supply at home o
Infants 30 mins before on empty, older child with something citric for the acid* o
Dietary counseling
Sickle Cell Anemia: Prevent Dehydration
• Etiology/Diagnostics: Hereditary, Autosomal recessive trait. Cells are sickle shaped.
Repetitive decrease in 02 cell walls become rigid. Cells are getting jammed, causing an
obstruction of RBC’s, resulting in PAIN. The normal HGB is replaced with abnormal HGB.
Effects the spleen.
o Organ that’s mostly effected is the spleen* o Newborn Screening in the US
• S/S- o Vascular inflammation
o Pain-> severe abdominal pain or chest. Mid to severe from 1 min-days -> crisis o
Stroke -> Severe unrelieved headache** o Painful Swelling: hands, feet, joint pain
o Headache. Doesn’t go away with meds? Possible CVA. EMERGENCY* o One
CVA? R/F another** (stroke) o Visual disturbances o Obstructive jaundice o Fever 101.3
or higher o Severe hypoxia
VASOCCLUSIVE Crisis: Acute chest syndrome: mimics pneumonia “painful episode”
• Splenic Sequestration: Pooling of blood in the spleen o Caused: Infection, stress,
dehydration* USE IV FLUIDS***, trauma
• Treatment- o DON’T over oxygenate
o Heat
o Prophylactic antibiotics: R/F infection* Preventing Infection*
, lOMoAR cPSD| 64639315
Vaccines, Antibiotics (PCN) o If they’ve had a stroke, every 3-4 weeks for
transfusions* to prevent CVA o Decrease 02 demands
o Oral/IV hydration, Oral at home to prevent hospitalization o Splenectomy
(severe)
o Stem cell Transplant: considered curative (severe)
o Rest
o Control Pain: Morphine o Electrolyte replacement Teaching:
o Prevent hydration o Rest
o Improve oxygen but don’t over oxygenate o Educate importance of vaccines o
Know s/s of a stroke o Child is normal just gets sicker easier
Hemophilia: Missing Clotting Factor
• Etiology/Diagnostics: Deficiency of factor VIII, produced by the liver, bleeding
disorder Education: Parents -> genetic counseling
• S/S:
o PROLONGED bleeding, kid will bleed longer than other kids, gums, cuts,
injections o Hemorrhage: At higher risk
o Bruising
o Hemarthrosis: blood in joints (knees, elbows, ankles) o Spontaneous Hematuria:
dark urine, blood
o Hematomas -> pain, swelling, limited motion
o Headache
o Slurred Speech o Loss of Consciousness o Black Tarry Stools= Bleed o Vomiting
coffee ground emesis o Bleeding gyms with teeth brushing
• Treatment: NO cure; lifelong o Replace VIII factor:
o Prevent bleeding: No IM vaccines, try subQ or less invasive first o Medications
Steroids
NSAIDS
DDAVP o Wear helmets
o Safety, protective equipment o Regular Exercise and Physical Therapy o Go to
doctor for sprains o Control Bleeding
R: Rest
I: ICE
C: Compress (cold)**
E: Elevate
Oncology
Pediatric Oncology
