NURSING CARE OF THE CHILD WITH A HEMATOLOGIC 儿童血液学的护理.pptVIP

NURSING CARE OF THE CHILD WITH A HEMATOLOGIC ALTERATION Disorders of the red blood cells RBCs are pale and smaller Iron Deficiency Anemia Most common anemia caused by improper iron intake Giving cow’s milk instead of baby formula is main culprit during the first year Adolescent girls are at risk because of menstruation Causes poor growth, poor test scores later Treatment Ferrous Sulfate for two months Restoration takes three months Retic count will increase 7-10 days after starting therapy Education Give between meals for better absorption Vit C increases absorption Milk and tea with meals reduces absorption Disorders of the red blood cells Macrocytic Anemias RBCs are larger than usual Megaloblastic Anemias Folic Acid Deficiency Causes in children Low birth weight Intake of powdered or goat’s milk Defective absorption S/S Poor weight gain Chronic diarrhea Management Folic acid Megaloblastic Anemias Pernicious Anemia Causes Lack of intrinsic factor, must be deficient ~ 2 years for symptoms to develop Management Vitamin B12 1mg daily x 1-2 weeks, then once weekly until HH are normal, then monthly for life Hemolytic Anemias Sickle Cell Disease Autosomal recessive, sickle shaped RBCs Asymptomatic in infancy prior to 5-6 months Clinical course characterized by episodic crises Management Pain relief, hydration, oxygenation DISORDERS OF BLOOD COAGULATION Hemophilias Hemophilia A (Factor VIII deficiency) Sex-linked recessive S/S Soft tissue bleeding and bleeding into joints Management Administration of factor VIII Von Willebrand’s disease Autosomal dominant Factor VIII defect, inability of platelets to aggregate, and inability of blood vessels to constrict Hemophilias continued S/S Bleeding, esp, from m.m. Management Factor VIII replenishment or DDAVP Christmas disease (Hemophilia B, Factor IX deficiency) Sex-linked recessive Treated with factor IX Hemophilia C (Factor XI deficiency) Autosomal recessive Symptoms are mild when compared to other types Immune Thrombocyto