lOMoAR cPSD| 57629747
NUR 254 Exam 4 Review - Exam 4 notes -
marked in red = key concepts
Maternal and Pediatrics (Galen College of Nursing)
, lOMoAR cPSD| 57629747
EXAM 4
Hematology and Oncology
• Assessment, analysis, planning, implementation, and evaluation
- CBC, H&P, energy level of child, food diary, iron sources, frequent infections, bleeding, skin
assessment: pallor, petechiae, and/or bruising
• Blood smear – blood cells should be normal in size, shape, color, number – if any irregularities can
indicate blood disorder Blood Transfusion Reminders: o Blood within 30 mins of arrival o Infuse
over 4 hours maximum
Hematology
Anemia – characterized by decrease in # of RBCs and/or Hgb which decreases O2 carrying capacity –
reduces O2 available to tissues – when anemia develops slowly in children the child adapts with
growth defects (Hgb less than 10) - anemia causes increased cardiac workload; may cause murmur
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, lOMoAR cPSD| 57629747
Nursing Care: o Treat underlying cause (transfusion after hemorrhage and/or
nutritional intervention)
o Provide supportive care (IV fluids, O2, bed rest)
o Prepare child & Family for lab tests: consider pain management interventions due to
sequential lab draws (use of topical anesthetic agents, distractions, etc.)
o Decrease tissue O2 needs: assess child’s energy levels & minimize excess demands –
allow self-care, cluster care to allow rest periods
o Prevent complications- prevent exposure to infections
o Support Family
o Iron rich foods: dark leafy greens
o Iron supplements Causes:
o Decrease in production of RBCs o Increase blood loss
o Increases destruction of RBCs in the body Symptoms/Other causes/TX:
1. SOB
2. Cool skin/pallor
3. Drugs/toxic substances
4. Immune conditions
5. Bone marrow failure
6. Epistaxis
7. Hemophilia
8. Pica
9. Weakness
10.Icteric Sclera
11.Low iron, low folate, low B12
12.Decreased peripheral pulses
13.Sickle Cell Disease
14.Dark urine
15.DIC
16.Low BP
17.Stop bleeding
18.B12 injections
messages.downloaded_by
NUR 254 Exam 4 Review - Exam 4 notes -
marked in red = key concepts
Maternal and Pediatrics (Galen College of Nursing)
, lOMoAR cPSD| 57629747
EXAM 4
Hematology and Oncology
• Assessment, analysis, planning, implementation, and evaluation
- CBC, H&P, energy level of child, food diary, iron sources, frequent infections, bleeding, skin
assessment: pallor, petechiae, and/or bruising
• Blood smear – blood cells should be normal in size, shape, color, number – if any irregularities can
indicate blood disorder Blood Transfusion Reminders: o Blood within 30 mins of arrival o Infuse
over 4 hours maximum
Hematology
Anemia – characterized by decrease in # of RBCs and/or Hgb which decreases O2 carrying capacity –
reduces O2 available to tissues – when anemia develops slowly in children the child adapts with
growth defects (Hgb less than 10) - anemia causes increased cardiac workload; may cause murmur
messages.downloaded_by
, lOMoAR cPSD| 57629747
Nursing Care: o Treat underlying cause (transfusion after hemorrhage and/or
nutritional intervention)
o Provide supportive care (IV fluids, O2, bed rest)
o Prepare child & Family for lab tests: consider pain management interventions due to
sequential lab draws (use of topical anesthetic agents, distractions, etc.)
o Decrease tissue O2 needs: assess child’s energy levels & minimize excess demands –
allow self-care, cluster care to allow rest periods
o Prevent complications- prevent exposure to infections
o Support Family
o Iron rich foods: dark leafy greens
o Iron supplements Causes:
o Decrease in production of RBCs o Increase blood loss
o Increases destruction of RBCs in the body Symptoms/Other causes/TX:
1. SOB
2. Cool skin/pallor
3. Drugs/toxic substances
4. Immune conditions
5. Bone marrow failure
6. Epistaxis
7. Hemophilia
8. Pica
9. Weakness
10.Icteric Sclera
11.Low iron, low folate, low B12
12.Decreased peripheral pulses
13.Sickle Cell Disease
14.Dark urine
15.DIC
16.Low BP
17.Stop bleeding
18.B12 injections
messages.downloaded_by
