anemia in children
S & SX: - ANSWER-pallor, brittle spoon shaped nails
irritability, muscle weakness
systolic heart murmur, enlarged heart, HF
iron supplements - ANSWER-give 1 hr before or 2 hr after antacid to prevent
malabsorpt
N/D and constipation common at start of therapy
use straw for liquid iron to prevent staining of teeth
aPTT - ANSWER-1.5-2X control range of 30-40 seconds
test clotting factors and monitor heparin therapy
increased aPTT - ANSWER-hemophilia
disseminated intravascular coagulation DIC
liver disease
PT - ANSWER-11-12.5 seconds, 85-100%
,increased PT time - ANSWER-evidence of deficiency or clotting
decreaed PT time - ANSWER-evidence of vit K excess= bleed out
acute hemolytic blood transfusion reactions - ANSWER-**low back pain,
TACHYcardia, HYPOtension
febrile reactions - ANSWER-30 min-6 hr after transfusion
-chills, fever, flushing, headache
use WBC filter, administer antipyretics
mild allergic reactions - ANSWER-during or up to 24hr after transfusion
- itching, urticarial, flushing
administer benadryl
RBC - ANSWER-females 4.2-5.4 million
males 4.7-6.1 million
decrease RBC - ANSWER-anemia
WBC - ANSWER-5,000-10,000
,elevated WBC - ANSWER-infection
decreased WBC - ANSWER-immunosuppression
Iron - ANSWER-females 60-160 mcg
males 80-180
elevated iron - ANSWER-hemochromatosis, iron excess
liver disorder, magaloblastic anemia
decreased iron - ANSWER-anemia or hemorrhage
platelets - ANSWER-150,000-4000,000
increased platelets - ANSWER-malignancy or polycythemia vera
decreased platelets - ANSWER-autoimmune disease
bone marrow suppression or enlarged spleen
Hbg - ANSWER-females 12-16
, males 14-18
decrease Hgb and Hct - ANSWER-anemia
Hct - ANSWER-females 37%-47%
males 42-52%
anaphylactic shock - ANSWER-wheezing, dyspnea, cyanosis, hypotension
maintain airway, admin O2, IV fluids, antihistamines, corticosteroids and
vasopressor
fluid overload - ANSWER-HYPERtension,
jugular vein distention, peripheral edema
orthopnea, crackles at base of lungs
sudden anxiety
sepsis and septic shock - ANSWER--fever, N/V, abdominal pain, chills HYPOtension
administer antibiotics, blood cultures, vasopressor (dopamine)
if disseminated intravascular coagulation (DIC) - ANSWER-admin heparin in early
stage