Term
| What are the precipitating factors to Sickle Cell Crisis? |
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Definition
Dehydration
Fever
Vomiting
Extremes of Temperature, Altitudes
Emotional Distress
Excessive exercise or physical activity
Alcohol consumption
fatigue |
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Term
| What are the complications of Sickle Cell Anemia? |
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Definition
Risk for severe hemolytic anemia
Splenic Sequestration Crisis
Stroke |
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Term
| What are the NI's for Sickle Cell Anemia? |
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Definition
Promote hydration - IV fluids, boluses,
Educate parents as to how many oz. of fluid the child needs each day and S/S of dehydration
Pain Management:
Medications, PCA's, Warm compresses for painful joints, positioning for comfort
Prevent infection
Educate parents to immediately seek care when child becomes ill
Prevent complications
Provide emotional support -support groups/counseling |
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Term
| What are the S/S of Splenic Sequestration Crisis? |
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Definition
Irritability
Unusual Sleepiness
Looks pale
Weakness
Fast heart beat
Enlarged spleen
Pain in the left side of the abdomen
LIFE THREATENING!!! CAN LEAD TO CARDIOVASCULAR COLLAPSE!!!!
Leading Cause of death in Sickle Cell Pts. |
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Term
| What are the causes of DIC? |
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Definition
infection (most common)
hypoxia
shock
trauma
burns
liver disease
cancer
viruses
fat embolism
hemolytic uremic syndrome
NEC
blood transfusion |
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Term
| What labs are seen in DIC? |
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Definition
PTT - prolonged
platelets - dec.
fibrin - inc.
fibrinogen - dec. |
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Term
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Definition
Supportive, bleeding control precautions
Mtr. for S/S of bleeding(IV sites, orafices, ect.)
ID and TX. of underlying cause
Administering fluids
Replacement of depleted coagulation factors |
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Term
| What are the S/S of Hemophilia? At what age is it DX? |
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Definition
S/S:
Spontaneous bleeding
Ecchymosis
Epistaxis
Hemarthrosis(bleeding into joints knees, elbows, ankles)
Hematuria
Dx. @ 6 mos. |
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Term
| What is the TX. for Hemophilia? |
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Definition
TX:
Control bleeding, replace clotting factor, prevent complications associated with bleeding
Pain Mgmt:
Pain meds., Elevate and immobilize affected joint, apply Ice Packs
Education for parents:
Safely measures
Observe for S/S of bruising, bleeding or changes in mental status
Mtr. color of stools for GI bleed
Provide emotional support
Support groups
Counseling may be required |
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Term
| What are Nursing Precautions for Hemophilia? |
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Definition
Avoid taking rectal temps. or giving suppositories
Check BP as infrequently as possible
Avoid IM and SC injections
DO NOT give aspirin
Use a fingerstick to obtain blood samples
Be careful when using tape on the skin |
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Term
| What is Idiopathic Thrombocytopenia Purpura(ITP)? |
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Definition
Also known as autoimmune thrombocytopenia
Characterized by destruction of platelets in the spleen
It is the most common bleeding disorder in children
Occurs most frequently in ages 2 - 10 yrs.
90% of cases go into spontaneour remission
More common in caucasians |
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Term
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Definition
Hx. of recent viral infection
Petechiae
Ecchymosis
Bleeding from the gums
Epistaxis
Hematuria
GI Bleeding
Platelet Count < 20,000 - 30,000 mm/dl
Antiplatelet antibodies in the blood
Normal RBC and WBC counts |
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Term
| What is TX. and NI's for IDP? |
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Definition
TX. dependant on platelet count presentation
Prevent bleeding and other complications
(preventative measures similar to hemophilia)
Restore platelet count
Corticosteroids
IVIG(intravenous immunoglobulin)
Tylenol for pain
Chronic ITP may req. immunpsuppresive drugs and a Splenctomy |
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