Nursing Care of The Child With Hematologic or Immunologic Dysfunction
Nursing Care of The Child With Hematologic or Immunologic Dysfunction
Nursing Care of The Child With Hematologic or Immunologic Dysfunction
with Hematologic or
Anemia
Dr.Raeda Amaireh
Nursing Care of the Child with Hematologic or
immunologic Dysfunction.
Anemia:
A condition in which the number of BBCS and/or the
Hemoglobin (Hb) concentration is reduced below normal.
As a result of this decrease, the 02 carrying capacity of
blood is diminished, causing a reduction in 02 available to
the tissues.
-S and S:
chronic anemia (Hb 6-9 g/dl), susceptibility to sepsis, strok,
visual disturbances, hematuria, obstructive jaundice,
pneumonia, severe abdominal pain, painful swelling of
hands and feet's, painful joints, cardiomegaly, systolic
murmur, progressive failure, liver cirrhosis and seizures.
Mosby items and derived items ©
2009, 2005 by Mosby, Inc., an
affiliate of Elsevier Inc.
-Therapeutic Management:
-Therapeutic Management:
Immunosuppressive therapy to remove presumed
immunologic functions that prolong aplasia.
• Bone marrow transplant.
• the care of the child with a plastic anemia is the same as
child with leukemia.
Hemophilia
Refers to a group of bleeding disorders in which there
is deficiency of one of the factor Hemophilia: necessary
for coagulation of the blood (Factor VIII deficiency).
-S and.S:
• Prolonged bleeding anywhere in the body.
• Hemorrhage from any trauma.
• Excessive bruising.
•Hematoma, spontaneous hematuria.
-Therapeutic Management:
• Replacement of the missing clotting factor.
• Non steroidal anti-inflammatory drugs (Ibuprofen) to relieve
pain.
• Prevent bleeding appropriate exercises and activities, safe
environment.
• For mouth care use sponge-tipped disposable tooth brush
or soften the tooth brush with warm water.
• SC injections are substitute for IM injection whenever
possible.
• Recognize and control bleeding RICE → Rest, Ice,
Compression and Elevation.
• Support family and prepare for home care.
Idiopathic Thrombocytopenic purpura (ITP):
Therapeutic Management:
- It's primary supportive, since the disease is self-limited in
the majority of cases.
-Treatment for acute presentation is symptomatic by giving
prednisone, I.V immunoglobulin, anti - D antibody.
-Splenectomy is generally recommended to wait until
child is more than 5 years of age because of increased
bacterial infection.
-Pneumococcal and meningococcal vaccines to be
given before splenectomy, in addition to prophylaxis
penicillin after splenectomy.
leukemia's:
Cancer of blood- forming tissues, is the most common
form of childhood cancer.
• Leukemia is abroad term given to a group of
malignant diseases of bone marrow and lymphatic
system.
• Leukemia is an unrestricted proliferation of
immature WBC's in the blood- forming tissues of the
body.
There are three consequences S and S:
1- Anemia - ↓RBC
2- Infection → neutropenia.
3- Bleeding tendency →↓platelets production.
Pallor, fatigue, pain, hemorrhage, splenomegaly, vomiting,
severe headache, muscle wasting, wt loss, Anorexia, fever,
tendency toward fractures.
-Therapeutic management:
It involves the use of chemotherapy in 4 phases
1. Induction therapy which achieves a complete remission
or less than 5% leukemia cells in the bone marrow.
2. CNS prophylactic therapy which prevents leukemia cells
from invading the CNS
3. intensification therapy (consolidation)→which eradicates
residual leukemia cells.
4. Maintenance therapy → which serves to maintain the
remission phase.
Nursing considerations:
• Prepare the child and family for diagnostic and
therapeutic procedure:
• Children must undergo several tests as lumber puncture,
blood tests .etc, therefore
• child needs explanation for each procedure and what can
be expected.
Relieve pain:
Dosage of opioids (narcotics) is adjusted to be
administered around the clock for optimal pain control
-Hodgkin Disease:
Is a neoplastic disease that originates in the lymphoid
system and primarily involves the lymph nodes. It's
prevalent in adolescence and young adults (15-19 yrs).
-S and S:
Painless enlargement of lymph nodes especially cervical
area, non productive cough, abdominal pain, low grade
fever, anorexia, nausea, wt. loss, night sweats, pruritus.
-Therapeutic Management:
PRECAUTIONS/NURSING
IMPLICATION SICNS/SYMPTOMS RESPONSIBILITIES
PRECAUTIONS/NURSING
AIPLICATION SICNS/SYMPTOMS RESPONSIBILITIES
PRECAUTIONS/NURSING
AIPLICATION SICNS/SYMPTOMS RESPONSIBILITIES
PRECAUTIONS/NURSING
AIPLICATION SICNS/SYMPTOMS RESPONSIBILITIES
PRECAUTIONS/NURSING
AIPLICATION SICNS/SYMPTOMS RESPONSIBILITIES
PRECAUTIONS/NURSING
AIPLICATION SICNS/SYMPTOMS RESPONSIBILITIES
PRECAUTIONS/NURSING
AIPLICATION SICNS/SYMPTOMS RESPONSIBILITIES
PRECAUTIONS/NURSING
AIPLICATION SICNS/SYMPTOMS RESPONSIBILITIES
transfused under
Sharp pain in chest
-pressure Clear tubing of air by
Apprehension
aspirating air with syringe at
nearest Y connect or if air is
observed in tubing;
disconnect tubing and allow
blood to flow until air has
escaped only if a Y connector
is not available
table (26-6).
PRECAUTIONS/NURSING
AIPLICATION SICNS/SYMPTOMS RESPONSIBILITIES
PRECAUTIONS/NURSING
AIPLICATION SICNS/SYMPTOMS RESPONSIBILITIES
Nausea, diarrhea
Electrolyte Use washed RBCS or fresh
Muscular weakness
disturbances blood if patient is at risk
Flaccid paralysis
Hyperkalemia (in
Paresthesia of
massive
extremities
transfusions or in
Bradycardia
patients with renal
Apprehension
problems)
Cardiac arrest