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Iron Deficiency Anemia is a ____ anemia brought about primarily by ___ dietary intake for normal RBC formation?
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What is the most common form of Anemia?
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Pediatrics
Hematological Conditions
| Question | Answer |
|---|---|
| Iron Deficiency Anemia is a ____ anemia brought about primarily by ___ dietary intake for normal RBC formation? | Iron deficiency anemia is a hypochromic microcytic anemia brought about primarily by inadequate dietary intake for normal RBC formaiton |
| What is the most common form of Anemia? | Iron Deficiency Anemia |
| IDA Diagnostic Criteria for Iron Deficiency Anemia for children between ___ months to ___ years is Hemoglobin ___ and Hematocrit ___ and you need both to diagnosis? | IDA Diagnositc Criteria children 6 months to 2 years Hemoglobin < 11g/dL Hematocrit < 33% Both needed to diagnose |
| American Academy of Pediatrics Iron Deficiency Anemia Degree of Anemia defines mild anemia as hemoglobin ___ to ___ g/dL | 9.5-11 g/dL 80% of cases are mild deficiency anemia |
| American Academy of Pediatrics Iron Deficiency Anemia Degree of Anemia defines moderate anemia as hemoglobin ___ to ___ g/dL | Moderate iron deficiency Anemia hemoglobin 8 to 9.4 g/dL |
| American Academy of Pediatrics Iron Deficiency Anemia Degree of Anemia defines severe anemia as hemoglobin ___ g/dL | Severe <8 g/dl |
| General etiologic factors of iron deficiency anemia is Inadequate dietary intake of ___; ___ malabsorption; Low ___ stores at birth (due to mothers ___ or ___) and significant ___ loss? | Inadequate dietary iron intake; iron malabsorption; low iron stores at birth (due to mothers intake or anemia) and significant blood loss (especially teenage girls (puberty)) |
| Premature/Low birth weight risk factors for iron deficiency anemia? | Poor iron stores at birth; maternal iron stores last approx 4 months; 50% of iron in maternal milk is absorbed; and 10% of iron in cow's milk is absorbed |
| Infant/Child risk factors for iron deficiency anemia: Rapid ___ in body size and blood volume; Insufficient ___ formula/foods; Excessive intake of ____ milk; ____ without dietary iron; Pica; ___ eater; nonmeat diet in a ___-__ year old; Malnutrition | Rapid increase in body size and blood volume; Insufficient iron rich formula/foods; Excessive intake of whole cow's milk; Breastfed without dietary iron; Pica; Picky eater; nonmeat diet in a 2-5 year old; malnutrition |
| What is Pica? | craving of a iron in a non-food source like nails, metals, clay, etc. usualy 6-8 months old |
| Adolescent risk factors for iron deficiency anemia are: rapid ___ during puberty; increased muscle mass and circulating ___ volume; Unbalanced __ and ___ eating habits; Menarche/heavy menstruation (usually __-__ years of age) | Rapid growth rate during puberty; Increased muscle mass and circulating blood volume; unbalanced diet and porr eating habits; menarche/heavy menstuation (usually 12-14 years old) |
| What are the adult risk factors for iron deficiency anemia? | Premenopausal women; pregnant women; chronic blood loss; low socioeconomic background (iron filled foods usually more expensive); older adult |
| What are the clinical manifestations of iron deficiency anemia? | Lethargy/fatigue; irritability; pallor; frequent infections; inability to concentrate; heavy menses; conjunctiva pale; mucous membranes pale; cardiac problems; developmental delays; and weight variable |
| What is pale conjunctiva and what are the cardiac problems seen in iron deficiency anemia? | conjunctiva pale is where the inside of the eye lid is not red and the cardiac problems are increased cardiac demands due to low/decreased hgb |
| Everyone gets tested for iron deficiency anemia between ___ and ___? | 9 - 12 months |
| American Academy of pediatrics recommendations for screening of ____ everyone tested between 9-12 months; only if child is symptomatic: 1 and 5 years; 5 and 12 years; and between 14 and 20 years? | iron deficiency anemia |
| T/F After toddler yrs iron deficiency anemia is usually due to dietary? | True |
| Breast milk has a ___ concentration of iron; Bioavailability greater, and progressive decline in ___ content? | Low concentration of iron, bioavailability greater, and progressive decline in iron content |
| Some breastfed infants depleate the iron stores by __ to __ months? They need a source of iron by ___ months like cereal? Without iron source __ to ___ will develop iron deficiency anemia by ___ months? | Some deplete iron stores by 4-6 months; Need source of iron by 6 months like cereal; without iron source 17-28% will develop iron deficiency anemia by 9 months |
| When do preterm infants get oral iron supplementation? | at 2 months of age (preterm considered if baby is less than 38 weeks) |
| Oral iron supplementation is needed if the baby is _____ beyond 6 months of age; infant receiving formula not fortified with iron; child with hemoglobin level below ___? | EXCLUSIVELY BREASTFED beyond 6 months of age; infant receiving formula not fortified with iron; child with hemoglobin level below 11 |
| Formula with iron is given until ___ months then Whole cow's milk after ___ months? Limit intake of whole milk to ___ or less in a child from 1-5 years? | Formula with iron until 12 months then whole cow's milk after 12 months. Limit intake to 24 oz/day or less in children 1-5 years of age. This amount is sufficient to meet calcium needs. Whole milk should be given because of the fat content in it. |
| What are some HIGH iron rich foods? | red meat and oily fish |
| What are some Moderate iron rich foods? | beans, peas, fortified cereals, dark green veggies, nuts |
| What are some foods that decrease iron absorption? | excess cow's milk, tea |
| ___ is an iron suplament given PO? | Ferrous sulfate |
| Do not consume ferrous sulfate with ___,___, or ____? | Do not consume ferrous sulfate with milk, antacids, or tea |
| What enhances ferrous sulfate absorption? | ascorbic acid enhances absorption (orange juice/Vitamin C) |
| If taking a liquid preparation of ferrous sulfate use dropper or straw to avoid _____ and be sure to ____ after? | liquid preparations use dropper or straw to avoid staining of teeth and be sure to brush teeth after |
| When do you wnat to give ferrous sulfate and what will the stools look like? | Give between meals especially if meal contains milk; stools dark (greenish-black)Only time you give it with meals is if a pt has side effects of it like upset stomach. |
| What are the side effects of ferrous sulfate? | nausea, vomiting, diarrhea, constipation, anorexia |
| when a pt is on iron supplements when should their hemoglobin return to normal? It should also come up 1.0 g/dL or more in ___ months? | Return to normal within 4-6 weeks; come up 1.0 g/dL or more in 1 month |
| Contine iron supplement/therapy at least ___ months after return of hemoglobin to normal; Tx should not exceed ___ months with exception to ___? | Continue at least 3 months after return of hemoglobin to normal; Tx should not exceed 5 months with the exception of older adults who may require life long supplementation |
| Parenteral iron and sometimes packed RBCs are given to pts with ____ anemia? | severe anemia |
| What is the prognosis of iron deficiency anemia? What are some problems/prognosis if it is longstanding/severe? | Prognosis is usually good. If longstanding/severe can lead to cognitive impairment; delayed G & D; Decreased exercise tolerance (decreased Hgb & o2 carrying RBC); Impaired immunity |
| Sickle cell Anemia is a ___ inheritance? It has an Abnormal form of hemoglobin within the erythrocyte. It has Hemoglobin ___ instead of the normal adult hemoglobin ___? | Sickle cell anemia is an autosomal recessive inheritance; abnormal form of hemoglobin within the erythrocyte--Hemoglobin S instead of the normal adult hemoglobin (Hgb A) |
| What is the normal lifespan of RBCs? What is it in Chronic Hemolytic Anemia (sickle cell anemia)? | Normal lifespan is around 90 days. in chronic hemolytic anemia red cell life span 10-20 days |
| Sickle cell anemia is an autosomal recessive inheritance. If Both parents heterozygous for trait what is the chance that the baby will be normal, a carrier, or have the disease? | 25% chance will have normal hgb A; 50% chance infant will be carrier (Hgb SA)and 25% chance infant will have disease Hgb SS |
| What is the incidence of sickle cell anemia? | Most common is African American descent; Caribbean/Mediterranean; Arabian; India |
| American Black population sickle cell anemia Disease is ___ to ___ live births and Trait is __ in ___? | Disease is 1:400 to 1:500 live births; Trait 1 in 12 |
| What are some situations/Stressors that promote O2 deprivation? | Hypoxia and acidosis; Environmental (low O2 concentration) High altitudes; weather; Emotional stress and physical stress and there are some unknown causes as well. |
| Hemoglobin S+ situations causing ____ leads to Sickled cells clumping togehter (cells __ and ___ can't flow through vessles) leads to small blood vessels becoming ____--> what side effects does this leed to? | Hemoglobin S+ situations causing Oxygen deprivation (ie stressors)-->Sickled cells clup together (cells hard and sticky-can't flow through vessels)--> small blood vessels become occluded-->Ischemia, Necrosis, Pain |
| Sickle cell disease is frequently not apparent until after __ to ___ months of age because of the continuing presence of ____? | Sickle cell disease is frequently not apparent until after 4 to 6 months of age because of the continuing presence of fetal hemoglobin |
| What are the 3 major types of sickle cell crisis? | Vaso-occlusive crisis; Splenic sequestration; and Aplastic crisis |
| What is daclylitis? | Dactylytis or sausage digit is a inflammation of an entire finger or toe,[1] and can be painful. |
| What is the most common sickle cell crisis and what are its side effects? | Vaso-occlusive Crisis is most common. Painful episode; clumping of RBCs, ischemia, infarction, pain |
| Splenic Sequestration is a sickle cell crisis; pooling of blood in ___-LIFE THREATENING; Decreased intravascular blood volume--> ____and if it is recurrent it will lead to ___? | Pooling of blood in SPLEEN-->LIFE Threatening; Decrased intravascular blood volume--> SHOCK; if recurrent it will lead to SPLENECTOMY |
| In a Aplastic crisis a ___ infection triggers it; RBC production ___ -->___ anemia; and it is usually self-limited? | Aplastic crisis Viral infection triggers; RBC production stops-->profound anemia; Usually self-limited |
| You are a nurse in an adult ED. A 24 yr old cl with sickle cell disease comes to the ER at least every 2 weeks complaining of pain and requesting pain meds. what do you need to do? | Analyze why this cl is being seen so often. Can't control at home; Look for stressful things in their life; List potential interventions like how to reduce stress |
| What are the 3 signs of sickle cell crisis? | Acute chest syndrome; Stroke; and Infection |
| What is Acute chest syndrome and what are the s/s? | Acute chest syndrome is the sickling of small blood vessels of lungs; s/s Pain; temp 38.3 (101 F) or higher; Cough; Dyspnea/Tachypnea; Respiratory distress |
| How do you treat Acute chest syndrome? | Hydration and pain management |
| Stoke is a sickle cell crisis. Sickle cells block major cerebral vessels. What are the s/s? | severe headache; slurred speech, unsteady walk |
| What are the leading cause of death under 10 years of age with a sickle cell pt? | Sepsis and Meningitis are the leading sickle cell cirisis deaths in pts under 10 years of age |
| Sickle cell crisis-Infection: Impairment of splenic function-Spleen replaced by ___ tissue related to infarcts in spleen (autosplenectomy)-loss of filtering system ___ susceptibility to infection--Nonfunctional by ___ years of age? | Spleen replaced by fibrotic tissue related to infarcts in spleen (autosplenectomy)-loss of filtering system increases susceptiblity to infection-nonfunctional by 5 years of age. |
| T/F Infection in sickle cell crisis basically means decreased functioning of spleen until it becomse absolete. so it doesn't do what it is suppose to do. | True |
| What is the most common organism for infection in sickle cell crisis for children under 5? Over 5? | Under 5 years-pneumococcalOver 5 years- gram negative (eg E.coli leading cause of UTI, Salmonella) |
| Nursing interventions for sickle cell anemia are ___management; Prevent/manage __; promote ___; Minimize tissue ___ & ___; drug therapy and patient/family ____? | Pain mangement (most important); prevent/manage infections; promote hydration; minimize tissue deoxygenation and minimize crises; drug therapy and patient/family education |
| What drugs do you want to use for severe pain in sickle cell pts? | Opioids parenterallyPCA or Continuous infusion pumps |
| What drugs do you wnat to use for Moderate pain in sickle cell pts? | Acetaminophen with codeine (vicoden) or ibuprofen |
| What drugs do you want to use for mild pain in sickle cell pts? | acetaminophen and ibuprofen |
| In managing pain it is important to observe for pain every __ to __ hrs? What do you want to ask them about their pain? | observe for pain every 2-4 hrs. Ask about location of pain, intensity, duration, and character (pounding) |
| T/F you don't need to use a pain intensity rating tool to monitor pain? | False use a pain intensity rating tool it monitor effetiveness of pain management |
| In sickle cell anemaia what are some other forms of pain management besides medications? | Heat-NO cold; Rest-minimize O2 consumption and HYDRATION |
| If a sickle cell anemia who is between ages 3 months and 12 years of age has to have dental work done what do they need to do? | Take Prophylactic penicillin; Pen VK |
| What are some ways to prevent infection in sickle cell anemia pts? | Prophylactic pennicllin; handwashing (very important); Isolation-as appropriate (not recommended unless absolute necessary); Immunizations; Teach |
| What immunizations should a sickle cell anemia pt get? | Routine; Meningococal; Influenza; Pneumoccoccal (prevnar and Pneumovax) |
| What do you want to teach a sickle cell anemia pt to report immediately if they are having? If they are having these symptoms prompt treatment with parenteral antibiotics like what? | Fever of 101 F (38.3 C); Lethargy; Irritability, Vomiting, Diarrhea. If they are having these symptoms prompt treatment with parenteral antibiotics like ceftriaxone. |
| T/F Hemodilution is not important in a sickle cell anemia pt? | False it is VERY IMPORTANT it reduces blood viscosity and prevents sickling IV + PO = 1 to 1.5 maintenance |
| What do you want to teach the family about hydration in a sickle cell anemia pt? | signs of dehydration-treat promptly; Child unable to concentrate urine-->low specific gravity leads to dehydration; Enuresis is common-DONT DECREASE FLUIDS |
| What do you want to teach the TEACHER of a sickle cell anemia child? | Teach them to allow child to drink fluids during class and to permit frequent use of bathroom |
| How do you minimize tissue deoxygenation in a sickle cell anemia pt? | Bed Rest-very important during acute crisis (need to maintain o2 level); Avoid stressors; Monitor O2 saturation; Administer O2 in a child with hypoxemia |
| How do you minimize crises in a sickle cell pt? | Avoid stressors; Report s/s of crises IMMEDIATELY; Frequent medical supervision; Adequate nutrion; Administer Blood transfusion if needed |
| Why would you want to give a blood transfusion in a pt with sickle cell anemia Acute splenic sequestration? In Aplastic Crisis? In Post CVA? | Acute splenic sequestration (correct hypovolemia); Aplastic crisis (PRBC to increase hemoglobin); Post CVA (reduce blood viscosity) |
| T/F Administering oxygen in a child with hypoxemia and sickle cell anemia will reverse the sickling? | False it does not reverse sickling it may prevent more sickling from occuring |
| Why do you want to give folic acid to a sickle cell anemia pt? | They have increased folate requirements caused by hemolysis and to prevent megaloblastic anemia |
| Hydroxyurea is used with frequent ___ episodes in sickle cell anemia pts? What does it do? | Hydroxyurea is used with frequent pain episodes in sickle cell anemia pts. It elevates Hemoglobin F which decreases sickling |
| T/F Erythropoietin is given to sickle cell anemia pts? | True |
| Patient/Family education of a sickle cell pt includes educating about all aspects of the disease; encourage ___ counseling; encourage family to promote normal ___; Allow expressions of feelings about the disease; Identify ___ and ___ resources? | Educate about all aspects of the disease; Encourage genetic counseling; encourage family to promote normal G&D; Allow expression of feelings about the disease; Identify community and national resources like kids w/ same disease and camps |
| The prognosis of sickle cell anemia is variable (depends on severity). What is the median survival age of Hgb SS Disease? | Men 42 years and Women 48 years both age groups keeps going up. The improved survival is due to Screening; Follow-up care; and early intervention |
| What is the most common hereditary bleeding disorders? | Hemophilia and vonWillebrand's Disease |
| Hereditary Bleeding disorders result from what? | result from deficiencies/abnormalities of specific coagulation proteins |
| T/F Deficiency of one of the factors in blood causes problems in the whole clotting cascade? | True |
| hemophilia A is a ___ linked recessive trate that is a deficiency of factor ___? | Hemophilia ADeficiency of factor VIIIX-linked recessive |
| hemophilia B is a deficiency of factor ___ and is ___ linked recessive? | Hemophilia BDeficiency of factor IXX-linked recessive |
| VonWillebrand's Disease is a ____ trait that is a deficiency of vonWillebrand's ____? | Deficiency of vonWillebrand's protein; Autosomal dominant |
| Hemophilia is a x-linked recessive disorder. What does this mean for a woman who is a carrier for the disorder and her partner does not have the disorder? | 50% chance each pregnancy-son will have the disease and 50% chance daughter will be a carrier. Depends on which X chromosome is passed on by mom |
| Impact of Factor VIII deficiency: Severe ___ factor activity and spontaneous bleeding w/out trauma; Moderate: __ to __ factor activity-bleeding with trauma; Mild: __ to __ factor activity-bleeding with severe trauma or surgery | Severe <2% factor activity-Spontaneous bleeding without trauma; Moderate: 2-4.9% factor activity-bleeding with trauma; Mild: 5-40% factor activity-bleeding with severe trauma or surgery |
| T/F With hereditary Bleeding disorders there is not a potential for bleeding anywhere in the body? | False there is a potential for bleeding anywhere in the body |
| What are the clinical manifestations of Hereditary bleeding disorders? | Potential for bleeding anywhere in the body and Hemarthrosis |
| What are the manifestations of hemarthrosis? | oozing of blood into joint cavity; Joint- swollen, tender, painful; repeated hemorrhage |
| What can a repeated hemorrage of hemarthrosis in a hemophilia pt do? | Damage to synovial membrane, degerneration of cartilege & cysts; Contractures; and severe crippling is possible |
| What are the nursing interventions for hereditary bleeding disorders? | Administer missing clotting factor; Injury prevention; control bleeding and teaching |
| Factor VIII Replacement: Administer ___ clotting factor as soon as possible with injury; New recombinat factor-has no human product in it (don't have to wory about diseases); Teach family & child how to ___; Implanted ___ access device may be necessary? | Administer missing clotting factor ASAP with injury; New recombinant factor-has no human product in it (don't worry about diseases); Teach family how to administer it at home; Teach child to self administer; Implanted venous access device may be necessary |
| hereditary Bleeding disorders Infant injury prevention: ___ crib; ___ feeding utensils; Wall-to-wall carpeting/pad edges of furniture; safe toys; approved car seat; ___ when learning to walk? | Pad crib; nonbreakable feeding utensils; wall-to-wall carpeting/pad dges of furniture; safe toys; approved car seat; helment when learning to walk |
| What type of protective equipment is need in a child/adolescent for injury prevention if they have clotting disorders? | knee pads, elbow pads, helmets |
| What kind of activities and sports can children/adolescents with clotting disorders do? | NO CONTACT SPORTS; No sports that cause too much strain on knees & ankles (hemarthrosis); Swimming is ok for young child; Swimming, golf, bowling, bike riding (with protective equipment) is okay for older child |
| Control bleeding in pts with clotting disorders with RICE. What does the R stand for? | Rest-immobilize for comfort and to prevent further bleeding |
| Control bleeding in pts with clotting disorders with RICE. What does the I stand for? | ICE-apply cold to promote vasoconstriction |
| Control bleeding in pts with clotting disorders with RICE. What does the C stand for? | COMPRESSION-pressure to encourage clot formation |
| Control bleeding in pts with clotting disorders with RICE. What does the E stand for? | Elevation-elevate joint |
| How do you prevent contractures in a pt with clotting disorders? Hint Gentle active ROM-only after __ stopped (w/in 24-48hrs) and allow cl to control own ___ tolerance; DO NOT do passive exercise-could __ joint capsule & could cause __w/ acute episode. | Gentle active ROM-only after bleeding stopped (w/in 24-48hrs) and allow cl to control own pain tolerance; DO NOT do passive exercise-could stretch joint capsule and could cause bleeding with acute episode. |
| What do you want to teach the family of a hemophilia or vonWillebrands's disease? | Home infusion therapy; signs of major bleeding; prevent bleeding; how to control bleeding; control pain; regular exercise & PT--strenghten muscles around joints; support family |
| What are signs of major bleeding? | Headache (HA); blurred vission, vomiting, lethargy, seizures |
| What are some things you can do to prevent bleeding? | soft toothbrush, no rectal temp, activity restrictions, environmental safety |
| What do you want to use to control pain in a Hemophilia pt and what do you NOT want to use? | Use acetaminophen (NO Asprin because it thins blood which would lead to increased risk of bleeding) |
| Life Expectancy of Hemophillia or vonWillebrands's disease is that it approaches that of ____ population and the major cause of death is _____? | approaches that of general population and major cause of death is intracranial hemorrhage |
| Idiopathic Thrombocytopenic Purpura (ITP) is a _____ hemorrhagic disorder? | Acquired hemorrhagic disorder |
| The potential Etiology of ITP is ____ response to disease-related antigens; ___ produced & attached to platelets; ___ of antibody coated platelets; and increased destruction of platelets (thrombocytopenia) in the ____? | Autoimmune response to disease-related antigens; Autoantibodies produced & attached to platelets; Phagocytosis of antibody coated platelets; and increased destruction of platelets (thrombocytopenia) in the spleen |
| The Acute Form of ITP is self-limmiting resolving within ___ with or without ____? It occurs __ to ___ weeks after viral infection (eg URI, measles, mumps, rubella, chickenpox, human parovirus); Incidence is most common in ____? | Self limiting resolving within 6 months with or without treatment (depends on how low the platelet count goes); occurs 1 to 4 weeks after viral infection (URI, measles, mumps, rubella, chickenpox, human parovirus); Incidence most common in children |
| Chronic form of ITP last longer than ___? What do you need to rule out? | Last longer than 6 months. Need to rule out immunodeficiency disorder; autoimmune disease; and neoplasm |
| Chronic form of ITP is most common in older ___ and women between __ & ___ years old? | Older children and women between 20 and 40 years old |
| What are teh clinical manifestations of ITP? | Bleeding of integument; mucous membrane bleeding; potential internal blood loss; and intracranial hemorrhage (<1%) |
| Bleeding of integument can be ___,___, & ____ they don't blanche? | Bleeding of integument can be Petechiae (<3 mm-pinpoint red dots); Purpura (up to 1 cm); and Ecchymoses (>1cm) and they don't blanche |
| Platelet count of ITP is decreased below ____? | 150,000 |
| If platelets are <50,000 it can cause prolonged ....? | prolonged bleeding from trauma or injury |
| If platelets are <20,000 it can cause ____? | can cause spontaneous life-threatening hemorrhage |
| What are the nursing interventions of ITP? | Primarily supportive, prevent &/or minimize bleeding, and administer medications |
| What 4 medications are given in ITP patients? | Predisone, IVIG, Anti-D antibody (WinRhoD), and Immunosuppressive Therapy |
| What is the Gold standard for treatment of ITP? | Predisone and IVIG are the gold standard for treatment of ITP |
| ___ is a medication that is inexpensive, may be given PO or IV and there is an ____ platelet survival and a ___ production of antiplatelet antibodies? | Predisone is inexpensive may be given PO or IV, increase platelet survival and a decrease production of antiplatelet antibodies |
| ___ is an expensive medication that blocks ____ that results in ___ of platelets? | IVIG is an expensive medication that blocks antibody that results in destruction of platelets |
| Anti-D Antibody (WinRhoD) lessens ___ of platelets? | Anti-D Antibody (WinRhoD) lessens phagocytosis of platelets |
| In ITP Immunosuppressive Therapy lessens ___ production? | lessens antibody production |
| ____ is usually self-limited and has indications of splenectomy? | ITP prognosis is usually self-limited and has indications of splenectomy |
| What are some indications of splenectomy? Hint unresponisve to ___; High doses of ____ are needed to maintain adequate platelet count, Manifestations for ___ or longer; and Decrease risk of _____ w/ chronic form of ITP | unresponisve to prednisone; High doses of prednisone are needed to maintain adequate platelet count, Manifestations for 1 yr or longer; and Decrease risk of hemorrhage w/ chronic form of ITP |
| What are some sources of lead poisoning? | Lead-based paint; soil, dust, air w/ lead particles; Water; Occupation & hobbies; Dinnerware; Cosmetics and fold remedies |
| What are the effects of lead on the cardiovascular system? | Hematopoietic --> anemia |
| What are the neurologic effects of lead? | Neurologic-> mental retardation, seizures, coma, and death |
| Waht are the renal effects of lead? | Renal--> acute renal failure, chronic renal failure |
| What does BLL stand for? | Blood Loss Level |
| Lead poisoning is defined as BLL ___ or greather than ____? | Lead poisoning is defined as BLL equal to or greater than 10 mcg/dl |
| Children with BLL greater than or equal to 10mcg/dl considered lead exposed and worthy of ___? | intervention |
| CDC recommends universal screening or target screening of lead poisoning based on each states determination of need. What is MOs? | Not mandated but required at 1 yr |
| Child/sibling w/ elevated past BLL; Lives in/regularly vists house build before 1959 or house built before 1978 w/ recent or ongoing renovation/remodeling in the last 6 months are all high risk children for ____? | High risk children for lead poisoning |
| Children who live in a building where other children are being followed or treated for elevated lead level; parents have occupational exposure are all high risk for ___? | lead poisioning |
| Child lives near an active lead smelter, or other industry likely to release lead into the environment (WV has high incidence) are all at high risk for ____? | lead poisioning |
| Red Flags of Lead poisioning: Foreign body ____, ___ seizures, neurological symptoms, ___ pain, Growth ___, Developmental ___ or hyperactivity? | Red flags of lead poisioning: foreign body ingestion/pica, unexplained seizures, neurological symptoms, abdominal pain, growth failure, developmental delay, or hyperactivity |
| ___ should be done in children with BLL 10 mcg/dl or above? | enviromental evaluation |
| Child with BLL above 25 mcg/dl needs ____? | needs chelation therapy |
| T/F strategies to reduce enviro lead hazards: keep child away from chipping, peeling, and flaking paint--temporarily cover this with contact paper, duct tape | True |
| T/F Wep mops floors, windows, and DO vacuum hard surface floors, window sills are all strategies to reduce enviro lead hazards? | False Wet mop floors, windows, etc. DO NOT vacuum hard surfaced floors, windows sills--spreads dust |
| T/F Washing toys &/or pacifiers often; wash childs face & hands often (especially before eating) and hose down places where children play (porch, driveway, sidewalk) are all strategies to reduce environmental lead hazards? | True |
| T/F Utilize warm water for drinking, cooking, formula preparation and avoid ceramic ware and lead crystal for food storage are all strategies to reduce environmental lead hazards? | False Utilize only COLD water for drinking, cooking, formula preparation and avoid ceramic ware and lead crystal for food storage |
| In a lead poisoned pt it is important to provide regular meals? why? Iron and calcium counteract ___ of minerals through lead exposure. | Regular meals important --> more lead absorbed on empty stomach. Diet high in Iron and Calcium counteract loss of these minerals through lead exposure |
| What are the 3 forms of Chelation Therapy? | Calcium EDTA IM or IV; Gritish antilewisite (BAL) IM; and Succimer (DMSA) Oral |
| Calcium EDTA IM or IV: Im painful-give deep, mix with ___, warm compress; monitor labs _____? | Calcium EDTA IM or IV: Im painful-give deep, mix with procaine, warm compress; monitor labs (eg BLL, electorlytes, liver function test) |
| British antilewisite (BAL) IM used with ___ and monitor ___ & ___? | British antilewisite (BAL) IM used with EDTA and monitor labs & ECG |
| Succimer (DMSA) Oral may give as outpatient, ___ is very important because it is excreted by kidneys? BLL > 45 | May give as outpatient and hydration is very important because it is excreted by kidneys. BLL > 45 |
| Adequate hydration is very important since ___ are excreted via kidneys? | Adequate hydration is very important since chelates are excreted via the kidneys |
| Prognosis of lead poisoning is variable and the major problems relate to ____? | Prognosis of lead poisoning is variable and the major problems relate to encephalopathy: academic problems; delinquency; mental retardation; behavior changes; paralysis and seizures |
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cgwayland
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