3.23 hematologic alteration
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What is iron deficiency anemia? What's normal Hct and Hgb values?
lack of iron in body leads to anemia. Body needs iron to make Hgb. No iron > no hgb > problems carrying o2.
why are babies and little kids more at-risk for iron deficiency anemia?
cow's milk don't have much iron. that may be all they drink. teach parents about breast-feeding and iron fortified cereals/foods.
what does a person look like with iron def. anemia? short term and long term.
short term: guy will look pale, be irritated and tired.
long run: nail bed deformations, tachycardia, will suffer from growth and developmental delay.
What is microcytic anemia? How would you know by looking at the CBC? What would the MCH read and how is it related? What are the causes of microcytic anemia?
small red blood cells. Normal MCV is 75-100. Lower than that means smaller cells. MCH is mean cell hgb. How much Hgb is in the cell. Lower concentrations means not much o2 can be carried > cell looks pale > "hypochromic".
- iron deficiency anemia
What is macrocytic anemia? What causes it?
- blood cells too big. Could be:
- Vit B12 deficiency
- impaired absorption
What is reticulocyte count?
measures how fast RBCs are being made and released. can help id anemia because RBCs are being destroyed prematurely.
What is tx for iron def. anemia? What are guidelines for giving Fe?
- protein + Vit.C to promote new cells.
- Don't give Fe with milk - will defeat purpose.
- The folic acid in juice will convert Fe to ferritin to Hgb. Give Fe on empty stomach. If can't tolerate, after meals. Will make shit black. Use straw to minimize teeth staining.
What are sources of Fe?
What races are at risk for SCD (sickle cell disease)?
blacks and Mediterranean
How do you test for SCD in a newborn?
test cord blood by electrophoresis
how do you test someone for SCD when they're over 6mo?
what are precipitating factors for SCD?
- physical stress
- emotional stress
what does a person with acute SCD look like?
- bone, joint, belly pain.
- swollen joints, belly, feet
what is the tx for SCD?
- NSAIDs (localized pain relief) and opiods (systemic pain relief) for the pain
- if that doesn't work, can move onto morphine
- IVFs with electrolytes.
- PCN (bc spleen isn't working rt, which usually combats bateria such as strep and H. influenzae)
The mother of a child with SCD is asking why a transcranial doppler is on the tx plan. Why?
early ID of increased risk for stroke d/t SC. those with abnormal results can reduce their risk thru monthly transfusions.
Why is a child with SCD and a fever a medical emergency?
because they are immunocompromised, a fever is a sign of bacteremia.
for SCD, do you use warm or ice packs for the hurting joints?
Hemophilia A is a lack of factor ____
Mother is a carrier for Hemophilia A. The boy is the one that gets it.
the joints hurt for a child with hemophilia A. do you use ice or warm packs?
What would you like to do?
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