NSG 6435 Exam queries and answers
graded A+
Hematologic and immunologic dysfunction assessment - ANS✅✅-Complete blood cell count
-History and physical examination
-Comments by the parent regarding child's lack of energy
-Food diary of poor iron sources
-Frequent infections
-Bleeding that is difficult to control
-Examine skin for pallor, petechial, and bruising
Anaemia - ANS✅✅-The most common hematologic disorder of childhood
-Decrease in number of RBCs or haemoglobin (Hgb) concentration below normal, or both
-Decreased oxygen-carrying capacity of blood
-Causes and physiology: depletion of RBCs or Hgb, or both; may be caused by a dietary depletion of
iron
-Morphology:
characteristic changes in RBC size, shape, or color, or a combination of these
-Signs and symptoms: lack of energy, easy fatigability, and pallor; cyanosis is typically not evident
-Diagnostic evaluation:
sometimes defined as Hgb <10 or 11 g/dL; however, this cutoff may be inappropriate for children
Aplastic Anemia:
-A condition that occurs when your body stops producing enough new blood cells.
-Treatment for aplastic anemia may include medications, blood transfusions, or a stem cell
transplant, also known as a bone marrow transplant.
-Pure red cell aplasia (PRCA) or erythroblastopenia refers to a type of anemia affecting the
precursors to red blood cells but not to white blood cells.
-In PRCA, the bone marrow ceases to produce red blood cells.
-Immune thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system
destroys platelets, which are necessary for normal blood clotting.
,-People with the disease have too few platelets in the blood.
-Disseminated intravascular coagulation (DIC) is a rare, life-threatening condition.
-In the early stages of the condition, DIC causes your blood to clot excessively.
-As a result, blood clots may reduce blood flow and block blood from reaching bodily organs.
Therapeutic Management of Anemia:
-Diagnosis: history and physical, CBC
-Treatment of underlying cause: transfusion after hemorrhage if needed; nutritional intervention for
deficiency anemias
-Supportive care: intravenous (IV) fluids to replace intravascular volume; oxygen therapy; bed rest
Care Management of
iron deficiency anemia - ANS✅✅-Caused by inadequate supply of dietary iron
-Generally preventable:
•Iron-fortified cereals and formulas for infants (WIC programs)
•Special needs of premature infants: reduced fetal iron supply
•Adolescents at risk because of rapid growth and poor eating habits
-Can get iron from red meat, beans, kale, raisins, some fruits
Pathophysiology:
-Caused by any number of factors: during last trimester, iron is transferred from mother to fetus
•Adequate 5 to 6 months in full term
•Only 2 to 3 months in preemies
-"Milk babies": •Overweight infant because of excessive milk ingestion
•2 reasons become anemic: milk (poor source of iron) and
increased fecal loss
-Therapeutic management: increase in the amount of iron the child receives
,-Prognosis: very good
-Nursing Care Management:
-Diet
-Iron supplementation:
•Adherence to oral iron supplement with appropriate administration
•Liquid preparation: may temporarily stain teeth; brush teeth after admin to lessen staining
If Your Child Has Iron Deficiency Anemia:
-Make sure your child takes the iron supplements exactly as prescribed.
-Include iron-rich foods in the family's diet.
-Good sources of iron include:
iron-fortified cereals, lean meat, poultry, fish, tofu, egg yolks, beans, and
raisins
-Serve fruits and vegetables high in vitamin C or a glass of orange juice at mealtimes. This helps the
iron get absorbed.
-Talk to a dietitian or your doctor if your child is a vegetarian. They can recommend foods to help
your child get enough iron.
-To help prevent iron-deficiency anemia in young children:
•Don't give cow's milk to babies under 1 year old.
•Limit cow's milk in kids over 1 year old to less than 2 cups of milk a day.
•Giving them more can make them feel full and lower the amount of iron-rich foods they eat.
sickle cell anemia - ANS✅✅-Partial or complete replacement of normal Hgb with abnormal HbS
-Defect is inherited
-Newborns with SCA are generally asymptomatic because of the protective effect from the mother
-Rapidly decreases during the first year, then child manifests symptoms
Causes:
-Autosomal recessive disorder:
•9% of African-Americans are carriers (have sickle cell trait)
•40% of native Africans are carriers
, •If both parents have the trait, each of their children has a 25% chance of having the disease
-In areas of the world where malaria is common, individuals with sickle cell trait tend to have a
survival advantage over those without the trait
Clinical Manifestations:
-Obstruction caused by sickled RBCs
-Vascular inflammation
-Increased RBC destruction
-Abnormal adhesion, entanglement, and meshing of rigid sickle-shaped cells
-Local hypoxia
-Cellular death
-Dactylitis is inflammation of a digit (either finger or toe) and is derived from the Greek word
dactylos meaning finger. The affected fingers and toes swell up into a sausage shape and can
become painful.
-Priapism is a prolonged erection of the penis. The persistent erection continues hours beyond or
isn't caused by sexual stimulation.
-Priapism is usually painful. Although priapism is an uncommon condition overall, it occurs
commonly in certain groups, such as people who have sickle cell anemia.
-Diagnosis: universal screening of newborns in the United States
Management:
-Prevent sickling
-Rest and minimize energy expenditure
-Hydration
-Electrolyte replacement: look at sodium, potassium, and magnesium (muscle spasms) values
-Analgesia
-Blood replacement
-Antibiotics
-Oxygenation
-Pain management
Prognosis:
graded A+
Hematologic and immunologic dysfunction assessment - ANS✅✅-Complete blood cell count
-History and physical examination
-Comments by the parent regarding child's lack of energy
-Food diary of poor iron sources
-Frequent infections
-Bleeding that is difficult to control
-Examine skin for pallor, petechial, and bruising
Anaemia - ANS✅✅-The most common hematologic disorder of childhood
-Decrease in number of RBCs or haemoglobin (Hgb) concentration below normal, or both
-Decreased oxygen-carrying capacity of blood
-Causes and physiology: depletion of RBCs or Hgb, or both; may be caused by a dietary depletion of
iron
-Morphology:
characteristic changes in RBC size, shape, or color, or a combination of these
-Signs and symptoms: lack of energy, easy fatigability, and pallor; cyanosis is typically not evident
-Diagnostic evaluation:
sometimes defined as Hgb <10 or 11 g/dL; however, this cutoff may be inappropriate for children
Aplastic Anemia:
-A condition that occurs when your body stops producing enough new blood cells.
-Treatment for aplastic anemia may include medications, blood transfusions, or a stem cell
transplant, also known as a bone marrow transplant.
-Pure red cell aplasia (PRCA) or erythroblastopenia refers to a type of anemia affecting the
precursors to red blood cells but not to white blood cells.
-In PRCA, the bone marrow ceases to produce red blood cells.
-Immune thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system
destroys platelets, which are necessary for normal blood clotting.
,-People with the disease have too few platelets in the blood.
-Disseminated intravascular coagulation (DIC) is a rare, life-threatening condition.
-In the early stages of the condition, DIC causes your blood to clot excessively.
-As a result, blood clots may reduce blood flow and block blood from reaching bodily organs.
Therapeutic Management of Anemia:
-Diagnosis: history and physical, CBC
-Treatment of underlying cause: transfusion after hemorrhage if needed; nutritional intervention for
deficiency anemias
-Supportive care: intravenous (IV) fluids to replace intravascular volume; oxygen therapy; bed rest
Care Management of
iron deficiency anemia - ANS✅✅-Caused by inadequate supply of dietary iron
-Generally preventable:
•Iron-fortified cereals and formulas for infants (WIC programs)
•Special needs of premature infants: reduced fetal iron supply
•Adolescents at risk because of rapid growth and poor eating habits
-Can get iron from red meat, beans, kale, raisins, some fruits
Pathophysiology:
-Caused by any number of factors: during last trimester, iron is transferred from mother to fetus
•Adequate 5 to 6 months in full term
•Only 2 to 3 months in preemies
-"Milk babies": •Overweight infant because of excessive milk ingestion
•2 reasons become anemic: milk (poor source of iron) and
increased fecal loss
-Therapeutic management: increase in the amount of iron the child receives
,-Prognosis: very good
-Nursing Care Management:
-Diet
-Iron supplementation:
•Adherence to oral iron supplement with appropriate administration
•Liquid preparation: may temporarily stain teeth; brush teeth after admin to lessen staining
If Your Child Has Iron Deficiency Anemia:
-Make sure your child takes the iron supplements exactly as prescribed.
-Include iron-rich foods in the family's diet.
-Good sources of iron include:
iron-fortified cereals, lean meat, poultry, fish, tofu, egg yolks, beans, and
raisins
-Serve fruits and vegetables high in vitamin C or a glass of orange juice at mealtimes. This helps the
iron get absorbed.
-Talk to a dietitian or your doctor if your child is a vegetarian. They can recommend foods to help
your child get enough iron.
-To help prevent iron-deficiency anemia in young children:
•Don't give cow's milk to babies under 1 year old.
•Limit cow's milk in kids over 1 year old to less than 2 cups of milk a day.
•Giving them more can make them feel full and lower the amount of iron-rich foods they eat.
sickle cell anemia - ANS✅✅-Partial or complete replacement of normal Hgb with abnormal HbS
-Defect is inherited
-Newborns with SCA are generally asymptomatic because of the protective effect from the mother
-Rapidly decreases during the first year, then child manifests symptoms
Causes:
-Autosomal recessive disorder:
•9% of African-Americans are carriers (have sickle cell trait)
•40% of native Africans are carriers
, •If both parents have the trait, each of their children has a 25% chance of having the disease
-In areas of the world where malaria is common, individuals with sickle cell trait tend to have a
survival advantage over those without the trait
Clinical Manifestations:
-Obstruction caused by sickled RBCs
-Vascular inflammation
-Increased RBC destruction
-Abnormal adhesion, entanglement, and meshing of rigid sickle-shaped cells
-Local hypoxia
-Cellular death
-Dactylitis is inflammation of a digit (either finger or toe) and is derived from the Greek word
dactylos meaning finger. The affected fingers and toes swell up into a sausage shape and can
become painful.
-Priapism is a prolonged erection of the penis. The persistent erection continues hours beyond or
isn't caused by sexual stimulation.
-Priapism is usually painful. Although priapism is an uncommon condition overall, it occurs
commonly in certain groups, such as people who have sickle cell anemia.
-Diagnosis: universal screening of newborns in the United States
Management:
-Prevent sickling
-Rest and minimize energy expenditure
-Hydration
-Electrolyte replacement: look at sodium, potassium, and magnesium (muscle spasms) values
-Analgesia
-Blood replacement
-Antibiotics
-Oxygenation
-Pain management
Prognosis:
