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Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers/
28 - The Child with Hematologic or Immunologic DysfunctionAce Your Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students
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Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers | Registered Nurse (RN) School Study Aid
WBC Differential Lab Value
- White Blood Cells (WBC)
- 5-10 (5,000-10,000)
- Leukocyte Differential
- Neutrophils (50%-70%)
- Bands (2%-5%)
- Segs (50%-70%)
- Lymphocytes (20%-40%)
- Monocytes (4%-8%)
- Eosinophils (2%-4%)
- Basophils (0.5%-1.5%)
2 mins
Whole Blood Composition
- Characteristics
- Plasma
- Electrolytes And Other Solutes
- Proteins
- Albumin
- Fibrinogen
- Globulins
- Water
- Formed Elements
- Buffy Coat
- White Blood Cells (WBC)
- Platelets
- Red Blood Cells (RBC)
2 mins
Erythropoietin
- Mechanism
- Stimulates RBC Production
- Indications
- Chronic Renal Failure
- Anemia
- Side Effects
- Increased Risk of Thrombosis
- Pelvic and Limb Pain
- Hypertension
- Considerations
- Do Not Shake
- Monitor Hemoglobin (Hgb) Weekly
- May Accelerate Tumor Progression
2 mins
Hemoglobin
- Hemoglobin Has Four Iron Hemes
- Lots Of Hemoglobin In Red Blood Cells
- High O2 Levels Increase O2 Binding
- High Temperature Reduces O2 Binding
- High CO2 Levels Reduce O2 Binding
- Low pH Reduces O2 Binding
- Myoglobin Binds Oxygen in Muscle
2 mins
Red Blood Cell Count (RBC) Lab Values
- Women: 3.5-5.5 million cells/ MuL
- Men: 4.3-5.9 million cells/ MuL
1 min
Hematocrit (Hct) Lab Values
- Women: 36% - 46%
- Men: 41% - 53%
1 min
Platelet Lab Value
- 150,000-400,000 Micro L
40 secs
Types of Blood Products
- Types
- Whole Blood
- Packed Red Blood Cells
- Fresh Frozen Plasma
- Immunoglobulins
- Clotting Factors
- Albumin
- Platelets
- Considerations
- Use within 24 Hours
- Washing Removes Antibodies
- Irradiation Destroys WBCs
2 mins
Blood Transfusion Administration
- Proper Patient Identification
- Large Bore Needle
- Y Tubing
- Baseline Vital Signs
- Slow IV Infusion
- Monitor During First 15 Minutes or 50 mL of Blood
- Monitor for Reactions
- Considerations
- Do Not Add Anything To Same IV Line
- No Dextrose or Lactated Ringers
- Jehovah's Witnesses, No Transfusions
3 mins
Transfusion Reactions
- Acute Hemolytic
- Febrile, Non-Hemolytic
- Mild Allergic
- Anaphylactic
- Circulatory Overload
- Sepsis Reaction
- Transfusion-Related Acute Lung Injury (TRALI)
- Massive Blood Transfusion
2 mins
Warfarin Antidotes
- Antidotes
- Vitamin K
- Fresh Frozen Plasma
59 secs
Iron (Ferrous Sulfate)
- Mechanism
- Ferrous Salts
- Indications
- Anemia
- Side Effects
- GI Distress
- Nausea and Vomiting
- Dark Stools
- Considerations
- Take Between Meals
- Liquid can Stain Teeth
- Keep out of Reach from Children
- Caution with GI Disorders
- Avoid Antacids
3 mins
Sickle Cell Anemia Assessment
- Cause/Mechanism
- Hemoglobin S (Genetic Defect)
- Sickle Shaped RBCs
- Assessment
- Jaundice
- Vaso Occlusive Crisis
- Fever
- Priapism
- Severe Pain
- Considerations
- Prominent in African Americans
- May be Asymptomatic
- Increased Risk of Infection
2 mins
Sickle Cell Anemia Interventions
- Interventions
- Increase Hydration
- Analgesics
- Oxygen
- Warm Compress
- Bone Marrow Transplant
- Hydroxyurea
- Considerations
- Avoid High Altitudes
- Prophylactic Antibiotics
- Avoid Strenuous Exercise
- Vaccines
3 mins
Meperidine (Demerol)
- Mechanism
- Opioid Receptor Agonist
- Indications
- Moderate to Severe Pain
- Post Anesthesia Shivering
- Side Effects
- Tremors
- Constipation
- CNS Depression
- Sedation
- Considerations
- Short Term Administration
- Increased Risk Serotonin Syndrome
- Does NOT cause Miosis
- Renal Failure Increases Toxicity Risk
2 mins
Clotting Overview
- Characteristics
- Endothelial Cells are Damaged
- Platelets Respond to Exposed Collagen and Stick
- Platelets Release Recruiting Factors
- More Platelets are Attracted
- Soluble Fibrinogen Turns to Insoluble Fibrin
- Fibrin Seals the Clot
- Clot Dissolves
- Liver Produces Clotting Factors
2 mins
Hemophilia
- Cause/Mechanism
- Genetic Mutation
- Assessment
- Prolonged Bleeding
- Pain
- Hemarthrosis
- Interventions
- Clotting Factor Replacement Therapy
- DDAVP (Desmopressin Acetate)
- Antifibrinolytic Therapy
- Analgesics
- Considerations
- Genetic Counseling
- Prevent Injury
3 mins
Bleeding Precautions
- Things to Avoid
- Hard Foods
- Aspirin Products
- Blowing Nose Forcefully
- Straining During BMs
- Enemas or Rectal Suppositories
- Pads and Monitor Menstruation
- Guidelines to Follow
- Soft-bristled Toothbrush
- Electric Razor
- Limit Needle Sticks
- Smaller Needle Size
3 mins
Disseminated Intravascular Coagulation (DIC) Assessment
- Mechanism
- Improper Initiation of Clotting Cascade
- Signs and Symptoms
- Systemic Bleeding
- Petechiae, Purpura, Ecchymosis
- Change in LOC
- Increased PT and PTT
- Cyanosis
- Increased Fibrin Degradation Products (FDP)
- Decreased Platelets and Fibrinogen
2 mins
Disseminated Intravascular Coagulation (DIC) Interventions
- Complications
- Risk for Shock
- Renal Failure
- Interventions
- Treat Underlying Cause
- Manage Bleeding
- Maintain Fluid and Hemodynamic Balance
- Transfusion
- Oxygenation
- Heparin Drip
2 mins
Innate Immunity Cellular Response
- Characteristics
- Natural Killer Lymphocytes Attack Abnormal Cells
- Neutrophils in Blood
- Infected Cells Release Interferon
- Complement Proteins Lyse Pathogens/Infected Cells
- Dendritic Cells in Tissue
- Macrophages in Tissue
2 mins
Immune System Tissues
- Characteristics
- Bone Marrow
- B Cells and T Cells Formed
- B Cells Mature
- Thymus
- T Cells Tested For Self-Response
- T Cells Mature
- Lymph Nodes
- Mature B Cells and T Cells Monitor Lymph For Pathogens
- Spleen
- Mature B Cells and T Cells Monitor Blood For Pathogens
1 min
Innate Immunity Barriers
- Skin Protects Against Pathogens
- Normal Flora Outcompete Pathogens
- Lysozyme in Saliva, Tears, and Mucus
- Mucous Traps Pathogens
- Cilia Remove Mucus
- Acid and Digestive Enzymes in the Stomach Kill Pathogens
2 mins
Humoral Adaptive Immunity
- Characteristics
- B Cell Binds Free Floating Antigen
- B Cell Presents Antigen to Helper T Cell
- Helper T Cells Help B Cells Develop Antigen Specificity
- Plasma B Cells Secrete Antibodies
- Memory B Cells Cause Faster Secondary Response
2 mins
Cell-mediated Adaptive Immune Response
- Characteristics
- Macrophages and Dendritic Cells Present Antigens
- T Cell Develops Antigen Specificity
- Regulatory T Cells Suppress Response
- Memory T Cells Cause Faster Secondary Response
- Cytotoxic T Cells Lyse Infected Cells
- Infected Cells Present Antigen On Surface
2 mins
Human Immunodeficiency Virus (HIV) Assessment
- Assessment
- RNA Retrovirus
- CD4+ Helper T Cells
- Primary Infection
- Flu-like Symptoms
- Lymphadenopathy
- Symptomatic Stage
- Fatigue
- Diarrhea
- Unexplained Weight Loss
- White Spots on Tongue
- Persistent Fever
- Night Sweats
2 mins
Human Immunodeficiency Virus (HIV) Stages
- Primary Infection
- Within 3 Weeks
- Flu-like Symptoms
- Asymptomatic Stage
- Years
- Symptomatic Stage
- CD4+ < 500
- AIDS
- Opportunistic Infections
- CD4+ < 200
2 mins
Human Immunodeficiency Virus (HIV) Diagnosis
- HIV-1/2 Antigen/Antibody Immunoassay
- HIV-1/2 Antibody Differentiation Immunoassay
- Nucleic Acid Testing (NAT)
- Viral Load
- Polymerase Chain Reaction (PCR) in Neonates
3 mins
Human Immunodeficiency Virus (HIV) Interventions
- Interventions
- Adequate Nutrition
- Small Frequent Meals
- IV Hydration
- Emotional Support
- HIV Medications
- HAART
- Considerations
- Transmission Education
- Strict Asepsis for Invasive Procedures
- Treat Opportunistic Infections
2 mins
