cellular regulation

prognosis of leukemia is based on what

WBC count

The nurse is caring for a variety of pediatric clients in the community health clinic. Which client is the nurse most concerned with being at risk for iron-deficiency anemia?

a 16-year-old, pregnant for the first time and lives with her parents

acute febrile illness

a sudden fever or elevation in body temperature

two main types of leukemia

acute lymphocytic leukemia (ALL) and Acute myelocytic leukemia (AML)

the child will become ______ during leukemia

anemic and thrombocytopenic

pancytopenia occurs in what

aplastic anemia

symptoms of acute chest syndrome

atelactesis, chest pain, pulmonary edema, pneumonia, fever, cough

iron supplements cause what

black and tarry stools

where is leukemia found

blood and bone marrow, may spread to other sites

splenic sequestration

blood pooling in the spleen causing enlargement and possibly infarction

where are lymphoblasts located

bone marrow

most common test for lukemia

bone marrow aspiration

key tst for leukemia

bone marrow biopsy

who is at higher risk for leukemia

boys

leukemia

cancer of the bone marrow

when is iron deficiency likely to occur

during rapid physical growth and low iron intake

lymphadenopathy

enlarged lymph nodes

aplastic anemia

failure of bone marrow to produce cells

RISK FACTORS OF pernicious anemia

family history, autoimmune disorder, chrons disease, intestinal infections, HIV, medications, lack of intrinsic factor

signs and symptoms of aplastic anemia

fatigue, dyspnea, tachy, pallor, bruising, blood in stool, bloody tongue

what fluids do you give in sickle cell

hypertonic fluid because these patients hold on to sodium

lab results for aplastic anemia

low RBC, low H&H, low WBC, low platelet

A child with sickle cell anemia comes to the emergency department for evaluation. The nurse suspects that the child is experiencing a vaso-occlusive crisis based on assessment of which signs and symptoms? Select all that apply.

low back pain fever distended abdomen

pernisious anemia lab results

low hgb&hct, low retic, high MCV, low B12

Thrombocytopenia

low platelet count

nadir

lowest neutrophil count

what do you avoid with iron supp

milk and calcium

general nursing interventions for sickle cell disease

monitor vital signs, assess respiratory status (high RR, increased WOB, low O2), altered LOC, monitor visitors

side effects of leukemia treatment

nadir, anemia, thrombocytopenia, mucositis, stomatitis, nausea and vomiting, constipation, hair loss, hepatotoxicity and nephrotoxicity

neutropenia occurs when

nutrophils are under 1500

CVA symptoms indicate what sickle cell disease

occlusion in the brain

milk of how much per day contributes to IDA

over 24 ounces a day

first nursing intervention for sickle cell

oxygenation, monitor for chest pain, ensure adequate gas exchange

most common reason for hospitalization sickle cell

pain episodes, vaso occlusion

third nursing intervention sickle cell

pain management

signs and symp of splenic enlargement

pallor, fatigue, abdominal pain, enlarged spleen

what happens during leukemia

proliferation of immature white blood cells

monitor for what in acute febrile illness

temp above 101.5, bacteria speticemia

splenic disfunction begins when sickle cell

6 months old

Following bone marrow aspiration of a client, analysis reveals more than 20% immature blast cells. Platelet counts are 9000/mm³. What nursing interventions should the nurse employ for the care of this client? Select all that apply.

Assess for mental state changes. Administer prescribed docusate daily.

treatment for pernicious anemia

B12 shots or pills, diet high in B12

sickle cell disease

Genetic disorder in which red blood cells have abnormal hemoglobin molecules and take on an abnormal shape.

what tests are done in leukemia

LFT and BUN

A nurse is caring for a patient who has a diagnosis of acute leukemia. What assessment most directly addresses the most common cause of death among patients with leukemia?

Monitoring for infection

A pediatric client is being screened for a macrocytic anemia? Which types of diagnosis would be considered? Select all that apply.

Pernicious anemia and anemia of folic acid deficiency

eventually what becomes affected in leukeimia

RBC and platelet function

hand foot syndrome

Swelling in the hands and feet usually is the first symptom of SCD. This swelling, often along with a fever, is caused by the sickle cells getting stuck in the blood vessels and blocking the flow of blood in and out of the hands and feet. Treatment: The most common treatments for swelling in the hands and the feet are pain medicine and an increase in fluids, such as water.

food high in B12

1. shellfish 2. liver(ORGAN MEAT) 3. Green leafy vegetables 4. Yeast 5. Milk 6. Cheese Pt who are vegan will have beefy red tongue

peak incidence of leukemia

2-10 years of age

how long is treatment for leukemia

2-3 years

normal ANC count

2000

hemoglobin levels

6-11

acute chest syndrome

A symptom associated with sickle cell anemia where sickle cells get trapped in the lung and cause infection

The registered nurse (RN) and licensed practical nurse (LPN) are preparing an educational program for clients who may be at risk for the development of iron-deficiency anemia. Which client(s) would receive the greatest benefit from this program? Select all that apply.

An adolescent with bulimia nervosa An older adult client on a fixed income A client with Crohn's disease

The nurse is caring for a child admitted with suspected leukemia. The nurse has taken the child's history and performed an assessment. The nurse will plan to prepare the child for which additional diagnostic test first?

CBC

A 7-year-old girl has been battling leukemia and receiving radiation therapy. She is highly susceptible to infections, and the nurse recognizes that this is because she is experiencing secondary immunodeficiency. What factors cause secondary immunodeficiency? Select all that apply.

Cancer Radiation therapy Severe stress Malnutrition

calcium binds to

IRON

when to give and what to give iron with

calcium and before meals

exposure to what can cause aplastic anemia

chemicals and toxins and pesticides

more tests for leukemia

chest x ray and lumbar puncture

early symptom of sickle cell

dactylitis

signs and symptoms of IDA

fatigue, lethargu, pallor, spoon nails, tachy, decreased oxygen level

second nursing intervention for sickle cell

fluid and electrolyte: assess for dehydration, urine output, fluid requirements

maintenance phase of leukemia

given over 2-3 years to maintain remission

consolodation phase of leukemia

given to prevent the disease from going to other parts of the body

nursing interventions for leukemia

handwashing, preventing infection, PO care, antiemetics

what additional risks should the nurse consider most on leukemia patient after infection

hemorrhage

pernicious anemia

inability of body to produce enough RBC's due to low B12

IDA often occurs as a result of

increased milk intake

three phases of leukemia

induction, consolodation, and maintenence

what is the most common cause of vaso occlusive crisis

infection

A nurse is teaching the parents of a child with sickle cell disease. The nurse determines that the teaching was successful when the parents identify which conditions as factors that predispose the child to a sickle cell crisis? Select all that apply.

infection and cold air temperature

most common nutritional anemia

iron deficiency

labs in order prior to administering chemo

renal function test, liver function test, H&H, platelet count, electrolyte count, WBC count

A nurse is preparing to discharge an adolescent with sickle cell anemia. What client need should the nurse emphasize in the discharge assessment?

the need for an adequate support structure

most common childhood cancer

leukemia

lab results for IDA

low HGB, HCT, MCV, MCH, MCHC, iron and ferritin

hypochronia

low blood volume

symptoms of pernicious anemia

nerve damage, osteoperosis, neuro problems, nausea, smooth thick red tongue, loss of appetite

induction phase of leukemia

patient is hospitalized for one month to immediatley induce remission

what is given for splenic disfunction

penicillin

Which signs and symptoms of leukemia would lead the nurse to suspect the client has thrombocytopenia? Select all that apply.

petechiae and epistaxis

A nurse is teaching the parents of a child with a hematologic disorder about ensuring proper nutrition. The nurse determines that the parents have understood the teaching when they identify which food as high in vitamin B12?

poultry

microcytosis

presence of small red blood cells

nursing management of IDA

promoting safety, ensuring adequate iron intake, education

what to teach parents IDA

proper nutrition and follow up with CBC and reticulocyte count

signs and symptoms of leukemia

purpura, bruising, pallor, fever, fatigue, weight loss, bone pain, enlarged spleen and liver, lymphadenopathy

iron sources in diet

red meat, fish, eggs, tofu, enriched grains, beans, leafy greens, dried fruits

complications of aplastic anemia

severe infection, hemorrhage, and death

what needs to be functioning properly before giving chemo

the kidneys

how long do people take iron supp

three months three times a day

reason for lumbar puncture in children

to see if the cancer has spread to the CSF

what is the purpose for allupurinol

it removes uric acid from the killed cells caused by chemo

treatment for splenic enlargement

iv fluids, RBC transfusion

anemia

lack of a normal number of red blood cells

what is the reason for prednisone in leukemia

prednisone alters the mitosis of the cancer cells

drugs for leukemia

prednisone, allupurinol and IV fluid, chemo agents

low platelet in aplastic amount

under 20,000

labs for leukemia

very low or very high WBC, low HGB, HCT, platelets