Nur 125 Peds Test 3: Part 1 Of 3 Anemias

Front 1

Most common blood disorder in children

Back 1

Anemia

Front 2

Baby (immature) red blood cells

Back 2

Reticulocytes

Front 3

Blood cell production

Back 3

Hematopoiesis

Front 4

Where does hematopoiesis occur?

Back 4

In the marrow of almost every bone (at birth).
The flat bones retain most of their hematopoietic (blood cell production) activity throughout life.

Front 5

The process in which red blood cells are formed

Back 5

Erythropoiesis

Front 6

What is the primary function of RBCs?

Back 6

To transport O2 from lungs to tissues.
They also help carry CO2 from tissues back to lungs.
(goal is to supply tissues with oxygen)

Front 7

Normal lifespan if RBCs

Back 7

120 days

Front 8

What happens when RBCs are destroyed?

Back 8

Spleen destroys RBCs when they are old/damaged
Most of the iron from RBC is stored for later use/development of new RBCs.

Front 9

What stimulates RBC production?

Back 9

Erythropoietin
(produced by kidney in response to hypoxia)

Front 10

What is Anemia?

Back 10

A term used to describe a decrease in the oxygen-carrying capacity of the blood.
This can be caused by a decrease in RBCs or decrease in hemoglobin.
Their are various types of anemias.
SYMPTOM - NOT A DISEASE!

Front 11

What are hypochromic RBCs?

Back 11

less color (pale)

Front 12

What are microcytic RBCs?

Back 12

Small in size

Front 13

Name the cellular blood components.

Back 13

Red blood cells
White blood cells
Platelets

Front 14

What does Hemoglobin in the RBC do?

Back 14

Carries the Oxygen

Front 15

What is the normal shape of a RBC?

Back 15

Biconcave
(Think Donut)

Front 16

What is the purpose of the biconcave shape of the RBC?

Back 16

Helps it to get thru capillaries to all tissues.
(Think of tubing thru the vessels - round, flexable shape keeps it from getting stuck)

Front 17

Hemoglobin & Hematocrit levels that signal anemia (in children).

Back 17

Hg < 10.5 – 11g/dl
Hct < 31.7-33%

Front 18

What are some causes of Anemia?

Back 18

Excessive blood loss
Destruction of red blood cells
Decreased or impaired production of red blood cells or components

Front 19

What are some cardiovascular symptoms of anemia (in children).

Back 19

Tachycardia
decreased capillary refill
(Heart pumps more blood in effort to get more O2 to cells)

Front 20

What are some respiratory symptoms of anemia (in children).

Back 20

Hypoxemia
increased respiratory rate
activity intolerance

Front 21

What are some central nervous system symptoms of anemia (in children).

Back 21

decreased level of consciousness
(not enough O2 to brain)

Front 22

What are some integumentary symptoms of anemia (in children).

Back 22

pale mucous membranes
pale skin
pale nailbeds
*look at conjunctivia*

Front 23

The most common heme disorder in kids

Back 23

Iron Deficiency Anemia

Front 24

What is the peak age range of iron deficiency anemia?

Back 24

6 mo - 2 yr
Teens

Front 25

Why are preemies susceptable to developing iron deficient anemia?

Back 25

Inadequate iron stores at birth.

Front 26

Why are toddlers susceptable to deveolping iron deficient anemia?

Back 26

Excessive intake of cows milk
(low iron intake; intestinal irritation can cause chronic, occult blood loss)

Front 27

Why are adolescents susceptable to developing iron deficient anemia?

Back 27

Poor dietary choices
Menses

Front 28

What happens with iron deficiency anemia?

Back 28

Their is insufficient iron in system to make Hg.
Hg is necessary to carry oxygen to tissues.

Front 29

Iron Deficiency Anemia may manifest as mild, moderate or severe. Describe signs seen in children for each category.

Back 29

Mild (Hg 9.5 - 11g/dl):
-often asymptomatic
-mild lethargy
Moderate (7 or 8 – 9.4g/dl):
-increasing irritability
-lack of interest in play
-easily fatigued
Severe (<7 or 8g/dl):
-pallor
-heart murmur
-brittle, spoon shaped nails
-hair falls out
-spleen enlargement
-longterm = delayed g&d

Front 30

Newborns have period of inactive erythropoiesis: Hg from broken down blood cells is stored in marrow & liver. How long does the full term & preemie iron stores last?

Back 30

Full term infant: up to 20 weeks after birth
Preemies: use up their stores by 6-12 weeks after birth

Front 31

Name a few dietary measures for preventing iron deficiency anemia.

Back 31

Breastfeeding (Iron in human milk more bioavailable than formula)
If formula fed use iron fortified one
Use iron fortified cereals when starting solids at 4-6 months
Limit intake of cow’s milk. Don’t start til after 1 yr.
Milk intake 1 quart/day or less; 24 oz/day better.
Start iron drops in preemies at 4 weeks

Front 32

Nursing Diagnoses for Iron deficiency anemia.

Back 32

Imbalanced Nutrition: less than body requirements
Knowledge deficit
Activity intolerance
Ineffective tissue perfusion (severe anemia/see more with sickle cell)
Risk for delayed growth and development (severe anemia)

Front 33

Lab results seen in iron deficiency anemia.

Back 33

Hg decreased
Hct decreased
Serum iron/ferritin decreased
Retic count WNL or high
Peripheral smear: Microcytic, hypochromic red cells
TIBC (total iron binding capacity) increased

Front 34

How do you treat iron deficiency anemia?

Back 34

Correct underlying problem & replace depleted iron stores
Increase dietary iron & Vit C
Supplements: Ferrous sulfate

Front 35

Iron deficiency anemia treatment is checked after 1 month. If pt is compliant with treatment but no improvement what will happen?

Back 35

Look for other causes of anemia

Front 36

How long is treatment for iron deficiency anemia?

Back 36

Continue therapy at least 2 months after labs return to normal.

Front 37

What are some common side effects of Fe supplements

Back 37

Nausea, heartburn
Abdominal cramping
CONSTIPATION
Diarrhea
BLACK/GREEN stools
Stains teeth

Front 38

What should you teach about iron supplements?

Back 38

-Give only the Rx’d amount
-Keep out of reach to prevent accidental overdose (This goes especially for chewable MVI – don’t treat it like candy!)
-Give liquid prep thru straw or with dropper toward back of mouth to prevent staining teeth or rinse mouth after admin.
-May need stool softener or gentle laxative if constipation a problem
-Note foods which may interfere with absorption: coffee, tea, dairy, eggs, whole grain breads, flouride, antacids…

Front 39

What are some sources of foods high in iron?

Back 39

Organ meats
spinach
oysters
peas
legumes
beef

Front 40

What are some medium dietary iron sources?

Back 40

Tofu
seafood
whole & enriched grains
wheat germ
oatmeal

Front 41

What are some low dietary iron sources?

Back 41

Peaches
prunes
dried apricots
potatoes
green beans
broccoli