CH27 KEYPOINT MATERNITY

Key Points

• Circulating blood consists of two portions: plasma and formed elements.

• Bone marrow aspiration is one procedure that is helpful in determining disorders of the blood.

• The most common nutritional deficiency of children in the United States is iron-deficiency anemia.

• Sickle cell disease is an inherited defect in the formation of hemoglobin. The cells become crescent shaped and clump together.

• Pain control with meperidine (Demerol) should not be used for children with sickle cell anemia.

• Massive expansion of the bone marrow in thalassemia causes changes in the contour of the child’s skull and face.

• Hemophilia A results from a deficiency in coagulation factor VIII, and hemophilia B (Christmas disease) involves a deficiency of factor IX.

• Hemarthrosis (bleeding into the joints) is a characteristic sign of hemophilia A.

• Hemosiderosis (deposits of iron in the organs and tissues) is a complication of multiple transfusions in hemolytic blood disorders.

• Signs of transfusion reactions include chills, itching rash, fever, and headache.

• Petechiae are bluish pinpoint lesions on the skin. Purpuras are groups of adjoining petechiae, ecchymosis is an isolated bluish lesion larger than a petechia, and a hematoma is a raised ecchymosis.

• Leukemia is the most common form of childhood cancer.

• Four priority challenges in the care of a child with leukemia are anemia, bleeding, infection, and fractures.

• Diagnostic procedures for patients with blood disorders are often invasive or painful. The nurse prepares and supports the patient and family during these procedures.

• Maintenance of schooling, adequate hydration and nutrition, prevention of infection, promotion of a positive self-image, and meticulous oral hygiene are essential components of nursing care for a child with leukemia.

• Reed-Sternberg cells are diagnostic for Hodgkin’s disease.

• Children who are chronically ill must be aided in mastering developmental tasks.

• The stages of dying according to Kübler-Ross include denial, anger, bargaining, depression, acceptance, and reaching out to help others.

• The nurse can help the family members of a dying child by listening and assessing their needs, reinforcing information, providing privacy, and using appropriate phrases and open-ended concrete questions and statements.