RBC

-formed

-functions (2)

-in bone marrow

-carry oxygen from lungs to tissues

-return carbon dioxide to lungs

WBC

-formed

Platelets

-formed

-most common type of anemia d/t nutritional deficiency

-9-11% of adolescent females d/t period

Short term: fatigue, pallor and irritability

Long term: clubbing, growth retardation, developmental delay, tachycardia and systolic heart murmur

Normocytic anemia

-definition

-cause

-s/sx

-tx

- RBC decreased in number but are normal size

-underlying condition, infection, inflammation and hemolytic uremic syndrome

-iron def and hepatomegaly and splenomegaly may also be present

-treat underlying cause

Sickle cell anemia

-cause

-hereditary

-normal hgb partially or completely replaced by abnormal hgb S

-fetal hgb present until 4-6 mo

- vaso-occlusive crisis

-splenic sequestration

-aplastic crisis

Aplastic anemia

-bone marrow does not produce all types of blood cells

-may be congenital or aquired

-pallor

-fatigue

-CHF

-Tachycardia

-weakness

-fever

-bacterial infections

-petechiae

-purpura

-bloody stool

-epistaxis

-retinal bleeding

-transfusions of packed cells and/or platelets

-immunosuppresive drugs

-hematopoetic stem cell transplant

hemophilia

-def

-stats

-x-linked recessive trait

-woman carrier has 50% chance of transmitting to son

-1/3 no family hx

-primarily in males

-no s/sx in females

-mild to severe bleeding

-asymptomatic until 6 mo

-bruise easy

-nose bleeds

-hematuria

-replace missign clotting factors

-DDAVP: 3 fold increase in factor

-gene therapy

-near normal life expectancy

ITP

-def

-stats

-spleen destroys platelets

-destruction exceeds production

-most common bleeding d/o in children

-peak age: 2-10

-usually follows a viral illness

-multiple bruises

-petechaie

-purpura

-bleeding from gums and nose

-blood in urine or stool

-corticosteriods

-IV IGGs

-60-80% have complete remission

-if no response 6 mo to a yr, splenectomy

Brain tumors

-stats

-most common solid tumor in children

-1 out of 5 childhood cancers

-etiolofy unknown; 5-10% genetic

-sugery

-radiation (not under 3)

-chemo

neuroblastoma

-def

-smooth, hard, nontender mass

-occurs anywhere along sympathetic nervous system chain

-common locations: abdomen, thoracic, adrenal and cervical

s/sx of neuroblastoma

-retroperitoneal

-mediastinal

-altered B&B

-wt loss

-enlarged liver

-dyspnea

-infection

-surgical removal

-follow with chemo

-radiation when not responsive to chemo

Wilms' tumor (nephroblastoma)

-def

-stats

-intrarenal tumor

-common abdominal tumor 6%

most common age: 41-47 months

-usually asymptomatic; HTN may occur

-located to one side of midline of abdomen

-surgery

remove affected kidney

-look for metastasis

-chemo with/without radiation

-most common tumor affecting the skeleton of children

-peaks during adolescent growth

-small, malignant bone tumor

-occurs in long shaft of bones (femur, tibia)

-may occur in any bone

-pain, may awaken child from sleep

-swelling

-limp

-lab abnormalities

-limb slavage or amputation surgery

-aggressive chemo

-metastasis is common

-chemo to reduce size

-surgery

-follow up chemo or radiation

-metastasis common

Leukemia

-def

-2 types

-most common form of childhood cancer

-abnormal proliferation of WBC

-AML

-ALL

-fever

-pallor

-overt signs of bleeding

-lethargy, malaise

-joint or bone pain

-enlarged liver, spleen and lymph nodes

-induction

-consolidation

-delayed intensification

-maintenance

-esophagus and trachea do not develop as parallel tracts

-esophagus ends at either blind pouch or connected to trachea by fistula

-hypertrophic obstruction of the pyloric sphincter

-occurs more in boys than girls 4:1 ratio

-results in obstruction of sphincter, inability to move food from stomach to duodenum and V/D

-a portion of the intestine prolapses and telescopes into itself

-results in obstructed blood flow, ischemia, necrosis and hemorrhage

-most cases in boys less than 2

-abnormal contents protrude into lung cavity

-when infant is born, crying pulls abdominal organs into thorax resulting in resp distress

-life threatening problem

-results from weak or imperfect closed umbilical ring

-common in children

-much more common in AA than caucasian

-effects 1/2 of all children

-1 in 300 infants

-congential

-portion of large intestine lacks parasympathetic innervation

-results in inadequate motility and obstruction of intestine

-monitor I&O

-replace fluids

-administer DDAVP

-home teaching

-growth hormone excess

-teach

-may assume child is older

-emotional support

-teach

-promote rest

-emotional support

-increase caloric intake

-fluid & electrolyte monitoring

-monitor calcium and phosphorus

-teach parents s/sx hypocalcemia