Maternal Child Chapter 27 Chapter 33 The Child With A Condition Of The Blood, Blood-Forming Organs, Or Lymphatic System, The Child With An Emotional Or Behavioral Condition

Front 1

Blood Dyscrasias

Back 1

Occur when blood components fail to form correctly or when blood values exceed or fail to meet normal standards.

Front 2

Hematopoiesis(blood formation)

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Childhood: RBC's are formed in the marrow of the long bones. Adolescence: takes place in the marrow of the ribs, sternum, vertebrae, pelvis, skull, cavicle, scapulae.

Front 3

Erythropoietin

Back 3

Regulates the RBC production. This is produced in the liver for the fetus and the kidneys after birth.

Front 4

The Lymphatic System

Back 4

drains regions of the body to lymph nodes, where infectious organisms are destroyed and anitbody production is stimulated.

Front 5

Lymphadenopathy

Back 5

an enlargement of lymph nodes that indicates an infection or disease.

Front 6

Spleen

Back 6

Largest organ of the lymphatic system. The main funtion is to bring blood into contact with the lymphocytes.

Front 7

Splenomegaly(spleen enlargement)

Back 7

Most commonly seen pathological condition of the spleen. Spleen enlarges during infections, congenital and acquired hemplytic anemias and liver malfunction.

Front 8

Bone Marrow Aspriation

Back 8

a procedure helpful in determining disorders of the blood.

Front 9

Petechiae

Back 9

Pinpoint hemmorrhagic spot

Front 10

Purpura

Back 10

Large Petechiae (hemmorrhagic spot)

Front 11

One of the bodys defense mechanisms

Back 11

increased size of tonsils and adenoids is normal in preschool and school age children

Front 12

Thymus Gland

Back 12

important in the development of the immune response in newborns.

Front 13

Immature T-Cell activity

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Preterm and term infants are at greater risk for viral and bacterial infections b/c of this

Front 14

Anemia

Back 14

most common nutritional deficiency of children in the US. Caused by insufficient of iron in the body. HIghest during infancy and adolescence. Anemia is a condtion in which there is a reduction of the size of RBC's or in the amoutn of Hemoglobin.

Front 15

Iron-Deficiency Anemia

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caused by severe hemorrhage, inabilty to absorb iron, excessive growth requirements, or inadequate diet. Feeding whole cows milk to infants can cause GI bleed resulting in anemia.

Front 16

Highest incidence of iron deficiency anemia

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occurs from nine to twenty four months.

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Solid food should be increased and milk decreased

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Boiled eggs, liver, leafy green veggies, cream of wheat, dried fruits,dry beans, crushed nuts, whole-grain bread & iron fortified cereal eaten out of the box.

Front 18

Symptoms of Iron Deficiency anemia

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pallor,irritability, anorexia, decrese in activity.
babies are over wt bc they get too much milk "milk babies"

Front 19

Blood Tests for Anemia

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RBC Count, Hemoglobin & hematocrit levels, determination of morphological cell changes and iron concentration. Stool can be tested for occult blood, dietary history obtained, spleen may be enlarged, slight heart murmur is heard.

Front 20

Untreated Iron Deficiency anemia

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progesses slowly, in severe cases heart muscles become too weak and heart failure follows. Children with long standing anemia may also show growth retardation, cognitive changes.

Front 21

Treatment of iron deficiency anemia

Back 21

Iron, usually furrous sulfate is given orally 2-3 times a day between meals. Vit C aids in absorption, Liquid preperations are taken through a straw to prevent discoloration of teeth. Iron dextran mixture also called IMFERON is given IM, must be injected deep in a large muscle using Z-track to minimize staining and tissue irritation.

Front 22

Oral supplements

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Should not be given with milk or milk products bc milk interferes with iron absorption.

Front 23

Sickling (clumping)

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caused by decreased blood oxygen levels may be triggered by dehydration, infection, physical or emotional stress or exposure to cold.

Front 24

Hemoglobin S

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The membranes of these cells are fragile, easily destroyed, their creasant shape makes it difficult for them to pass through capillaries causing a pile up of cells in the small vessels. Can lead to thrombosis and can lead to obstruction.

Front 25

Sickle cell trait

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occurs in about 10% of African Americans . The blood of the patient contains a mixture of normal hemoglobin A and hemoglobin S. The proportions of HS is low b/c the disease is inherited from only on parent. In the sickle cell trait the hemoglonin and RDC counts are normal. Sickle trait does not develop into sickle cell disease.

Front 26

Offspring of parents with sickle cell

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have 1 in 4 chance of inherting and a 2 in 4 chance of being a carrier.

Front 27

Sickle cell Anemia

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1-4 chance child will inherit.
Results when the abnormality is inherited by both parents. Clinical symptoms usually do not occur until the last part of the first year. may be unusual swelling of fingers and toes. are caused by enlarging bone marrow sites that impair circulation to the bone and the abnormal sickle cell shape that causes clumping, obstruction of the vessel, and ischemia to the organ that the vessel supplies.

Front 28

Chronic Anemia

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hemoglobin ranges from 6-9 or lower. Child is pale, tires easily and has little appetite.

Front 29

sickle crisis

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painful and fatal, patient will appear acutely ill. have severe abdominal pain,muscle spasms, leg pain, painful swollen joints, fever, vomiting, hematuria, convulsions, stiff neck, coma, peralisis. Children with sickle cell disease have a risk for stroke as a complication of a vasoocclusive sickle cell crisis. Sickle cell crisis recur periodically throughout childhood and tend to decrease with age.

Front 30

Sickledex

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Test for sickle cell disease

Front 31

Hemosiderosis

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Deposit or iron into organs and tissues in the body

Front 32

Christmas disease

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Aka hemophilia b, a factor IX deficiency

Front 33

Hemarthrosis

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Hemorrhage into joint cavity

Front 34

Ecchymosis

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Isolated bluish lesion larger than a petechia

Front 35

Hematoma

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Raised ecchymosis

Front 36

Oncologists

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doctors who specialize in the treatment of tumors

Front 37

Alopecia

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hair loss

Front 38

Respite care

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Come to home to relieve parents of caring for the child

Front 39

hodgkin's disease

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*malignancy of the lymph system, especially the lymph nodes
*radiation & chemotherapy
*painless lump along neck
*rarely seen before 5 y.o

Front 40

Leukemia

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*group of malignant diseases of the bone marrow and lymphatic system
*2 common types- (ALL) acute lymphoid leukemia and nonlymphoid (myelogenous) leukemia (AML)
*uncontrollable growth of WBCs
*chemotherapy
*most common form of childhood cancer

Front 41

platelet disorders

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reduction or destruction of platelets in the body interferes with the clotting mechanism; petechiae, purpura, ecchymosis, and hematoma

Front 42

hemophilia

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*disease of kings
*classic syndrome is bleeding into the joints (hemarthrosis)
*sex-linked recessive trait
*located on X-chromosome
*hemophiliae A 84% of cases
*deficiency clotting factor VIII (coagulation)

Front 43

anemia

Back 43

*most commonly caused by insufficient amounts of iron
*reduction in amount of cirulating hemoglobin reduces oxygen-carrying ability of blood
*S&S- pallor, irritability, anorexia, decrease in activity

Front 44

Sickle cell disease

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*dominant in African Americans to prevent malaria
*abnormal form of hemoglobin (hemoglobin S)
*crescent shapes, can't pass through capillaries so they pile up and "clump"
*may lead to clot
* sickle cell trait- carrier
* sickle cell anemia- recessive gene inherited from both parents

Front 45

Thalassemia

Back 45

*group of hereditary blood disorders in which the patient's body cannot produce sufficient adult hemoglobin
*RBC's are abnormal in shape and size and are rapidly destroyed, results in chronic anemia
*two types- thalassemia minor- one gene is inherited
- thalassemia major( Cooley's anemia)- two genes are inherited
*massive expansion of the bone marrow in thalassemia causes changes in the contour of the child's skull and face

Front 46

Pain control with ______ should not be used for childdren with sickle cell anemia

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Demerol, may induce seizures

Front 47

Hemophilia A results from a deficiency in coagulation, or factor ____.

Back 47

VII

Front 48

Hemophilia B (Christmas disease) involves a deficiency of factor ____.

Back 48

IX

Front 49

hemosiderosis is a complication of

Back 49

multiple transfusions in hemolytic blood disorders

Front 50

Signs of transfustion reactions include:

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chills, itching, rash, fever, and headache

Front 51

four priority challenges in the care of a child with leukemia are:

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anemia, bleeding, infection, and fractures

Front 52

Kubler-Ross stages of dying

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*denial *anger *bargaining *depression *acceptance *reaching out to help others

Front 53

Where might you be able to palpate lymph nodes in child?

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axillary, inguinal, cervial

Front 54

Thrombocytes and plasma help to do what

Back 54

blood coagulate

Front 55

Lymphocytes

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(unlike WBCs) Produce lymphoid tissue of body

Front 56

Types of sickle cell crisis

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Vasoocclusive- painful, most common, obstruction of blood flow, vasospasm.

Splenic Sequestration- blood in liver/spleen, circulatory shock, death in hours, spleenectomy

Aplastic crisis- bone marrow stops producing RBCs, transfusion

Hyperhemolytic- rare, fibrosis of spleen, rapid hemolysis

Front 57

Dont use ____________ with kids with anemia

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salicylates

Front 58

Idiopathic Thrombocytopenia Purpura

Back 58

Most common purpura.
Affects platelets and functions
Autoimmune reaction
Platelets coated with antiplatelet destroyed by spleen.
30% nose bleeds
Platelet count= 20,000 (norm= 150k-200k)
Decreased platelet count can cause intracranial bleeding
After admin of anti-d watch for 1 hour for s/s

Front 59

art therapy

Back 59

helpful dealing with younger children who have difficulty expressing themselves (drawing pictures)

Front 60

behavior modification

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focuses on modifying specific behaviors by means of stimulus and response conditioning

Front 61

bibliotherapy

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reading of stories about children in a situation similar to the child's situation

Front 62

Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision) (DSM-IV-TR)

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resource that defines mental disorders and is used by health professionals to aid in diagnoses of specific mental health conditions

Front 63

dysfunctional

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situations that disrupt family patterns can have a lasting impact on the child

Front 64

family therapy

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includes all family members

Front 65

intervention

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may involve individual, family, or group therapy

Front 66

milieu therapy

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refers to the physical and social environment provided for the child

Front 67

play therapy

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helpful dealing with younger children who have difficulty expressing themselves (playing with dolls, etc)

Front 68

psychosomatic

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come to refer to the dysfunctions of the body that seem to have an emotional or a mental basis

Front 69

recreation therapy

Back 69

....

Front 70

sibling rivalry

Back 70

competition between siblings for the attention or love of parents, is a normal part of growth and development, but guilt on the part of the other siblings enters the picture when one sibling becomes ill