The chapter discusses conditions of the blood, blood-forming organs, and lymphatic system in children. It covers hematological conditions including anemias like iron-deficiency anemia and sickle cell disease. The lymphatic system and its role in the immune system is described. Specific blood disorders in children such as thalassemia, hemophilia, and their inheritance patterns and manifestations are explained. Treatment involves maintaining hemoglobin levels, blood transfusions, iron chelation therapy, and clotting factor replacement for hemophilia.
Impact of cancers therapies on the loss in cardiac function, myocardial fffic...
Chapter 27 Power Point
1. Chapter 27Chapter 27
The Child with a Condition of theThe Child with a Condition of the
Blood, Blood-Forming Organs, orBlood, Blood-Forming Organs, or
Lymphatic SystemLymphatic System
49. Manifestations of LeukemiaManifestations of Leukemia (cont.)(cont.)
• WBCs not functioning
normally, increases
risk of infection
• Ulcerations develop
around the mucous
membranes of the
mouth and anal
regional
– Gums tend to bleed
49
Discuss the reasons this age group is more susceptible to iron-deficiency anemia.
Refer to Nursing Care Plan 27-1 on page 628.
Discuss the pathophysiology of the causes of sickling.
Discuss the complications of hemosiderosis.
Audience Response Question #1
A 12-month-old child is admitted to the emergency department in sickle cell crisis. Her symptoms might include:
1. severe itching, vomiting.
2. fever, seizures, coma.
3. abdominal pain, swollen painful joints.
4. polycythemia, tachycardia.
Discuss the chances of a child inheriting sickle cell disease.
Discuss the pathophysiology of the pain the child experiences.
Describe each crisis listed.
Discuss how these nursing interventions assist the child with a sickle cell crisis.
Discuss methods which could prevent sickling, dehydration, hypoxia, and infection.
What ethnic population is mainly affected by thalassemia? Mediterranean
Define milk anemia.
What are symptoms of thalassemia minor?
Discuss Figure 27-5 on page 632.
What is the rationale for radiographic studies of the bones?
Discuss types of blood tests which would be ordered for a child with thalassemia major.
Describe electrophoresis.
What activities would promote growth and development for this child?
Discuss signs and symptoms of a child reacting to a blood transfusion.
What nursing interventions would promote emotional health of the child and the family?
Discuss how PTT can detect this disorder.
Discuss the pathophysiology of the symptoms listed.
What procedures might be delayed for the newborn?
Discuss which disciplines would be good resources for the family coping with a child who has hemophilia.
Discuss the rationale for avoiding salicylates.
Describe petechiae, purpura, ecchymosis, and hematoma.
Audience Response Question #1
Complete the analogy. Hemophilia : actor VIII as ITP : ________.
1. WBCs
2. RBCs
3. hemoglobin
4. platelets
Discuss the procedure for bone marrow aspiration.
Discuss a proper neurological assessment.
What is the rationale for a splenectomy?
Discuss the pathophysiology of fibrosis and its effects on these organs.
Discuss the pathophysiology of the symptoms listed.
Discuss Figure 27-6 on page 635.
Discuss what changes could be seen upon X-ray of the long bones.
What are the effects of chemotherapy on the kidneys and the liver?
Discuss who would be involved in the care of a child with leukemia.
Discuss the education of parents and family in preventing infection.
What is the rationale for avoiding immunizations during the treatment regimen? The body will not be able to manufacture antigens as expected.
Give an example of why oral care is important.
Discuss each of these stages of the treatment regimen.
Audience Response Question #3
Which intervention is best to help prevent or reduce nausea and vomiting during chemotherapy?
1. Encourage increased fluid intake.
2. Administer an antiemetic immediately following treatment.
3. Promote diversional activities.
4. Administer an antiemetic 30 minutes before treatment.
What are ways to assess for infection?
Discuss nursing interventions to provide good hygiene.
What are some signs of a transfusion reaction? Chills, itching, rash, fever, headache, and pain in the back
What should the nurse do if a transfusion reaction occurs? The transfusion is immediately stopped, a normal saline line is immediately opened, and the primary caregiver and hospital blood bank are notified.
What are signs of circulatory overload? Dyspnea, precordial pain, rales, cyanosis, dry cough, and distended neck veins
If circulatory overload occurs, what are the appropriate actions? Be prepared to administer medications and supplemental oxygen.
What information will parents and the family need in caring for this child?
Discuss Nursing Care Plan 27-2 on pages 639-640.
Discuss the nurse’s role in managing a child and family when dealing with a chronic illness.
Why is respite care for the family important?
Discuss issues the nurse would assess regarding home management of the child’s care.
Review Table 27-3 on page 641.
How can the nurse involve the family in the care of a chronically ill child?
Discuss the grieving process.
Give examples of cultural beliefs regarding death.
Give examples of how a nurse could support a parent who is angry at the loss of a child.
Review the Health Promotion box on page 643 and Nursing Care Plan 27-3 on pages 644-645.
How would the nurse explain the dying process to the parents?
How will you know if your teaching was effective?
Discuss and provide examples of how the nurse can assist an individual through each stage.