Chapter 43: Hematologic and Immunologic Dysfunction

Notify the health care provider if a fever of 38.5° C 101.3° or greater occurs. Give penicillin as prescribed.Notify the health care provider if your child begins to develop symptoms of a cold

.recognize signs and symptoms of splenic sequestration, as well as respiratory problems that can lead to hypoxia; and (4) treat the child normally.

Signs of air embolism are sudden difficulty breathing, sharp pain in the chest, and apprehension.

8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough.

Aplastic anemia refers to a bone marrow-failure condition in which the formed elements of the blood are simultaneously depressed

A possible cause of acquired aplastic anemia in children is: Drugs.Drugs such as chemotherapeutic agents and several antibiotics such as chloramphenicol can cause aplastic anemia.

Syngeneic marrow is from an identical twin Autologous refers to the individual's own marrow.

A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. most appropriate nursing action to prevent or minimize these reactions with subsequent treatments

As related to inherited disorders, which statement is descriptive of most cases of hemophilia?X-linked recessive inherited disorder in which a blood-clotting factor is deficient

An acquired hemorrhagic disorder that is characterized by excessive destruction of platelets is:Idiopathic thrombocytopenic purpura.

Individuals who live near the Mediterranean Sea and their descendants have the highest incidence of thalassemia. An overproduction of red cells occurs. Although numerous, the red cells are relatively unstable

Chelation therapy is begun on a child with B-thalassemia major. The purpose of this therapy is to:Eliminate excess iron.

The nurse is preparing to give oral care to a school-age child with mucositis secondary to chemotherapy administered to treat leukemia. Which preparations should the nurse use for oral care on this child

Chlorhexidine gluconate Peridex Antifungal troches lozenges Lip balm (Aquaphor)

The parents of a child with cancer tell the nurse that a bone marrow transplant may be necessary. What should the nurse recognize as important when discussing this with the family?

Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system.

A complication of the frequent blood transfusions in thalassemia is iron overload. Chelation therapy with deferoxamine an iron-chelating agent is given with oral supplements of vitamin C to increase iron excretion

In which condition are all the formed elements of the blood simultaneously depressed? Aplastic anemia

Avoidance of intramuscular (IM) injections Acetaminophen (Tylenol) for mild pain control Soft toothbrush for dental hygiene

Parents of a school-age child with hemophilia ask the nurse, "Which sports are recommended for children with hemophilia?" Which sports should the nurse recommend

An accurate description of anemia is:Decreased oxygen-carrying capacity of blood.

Several blood tests are ordered for a preschool child with severe anemia. She is crying and upset because she remembers the venipuncture done at the clinic 2 days ago. The nurse should explain that:

An inherited immunodeficiency disorder characterized by absence of both humoral and cell-mediated immunity is: Severe combined immunodeficiency syndrome (SCIDS).

Several complications can occur when a child receives a blood transfusion. An immediate sign or symptom of an air embolus is:

Myelosuppression associated with chemotherapeutic agents or some malignancies such as leukemia can cause bleeding tendencies because of a/an: Decrease in blood platelets.

The decrease in blood platelets secondary to the myelosuppression of chemotherapy can cause an increase in bleeding

Topical application of local anesthetic can eliminate venipuncture pain.

The most appropriate nursing diagnosis for a child with anemia is: Activity Intolerance related to generalized weakness.

An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that the bone marrow will be administered by which route? Intravenous infusion

The nurse is caring for a child with aplastic anemia. Which nursing diagnoses are appropriate Risk for Infection related to inadequate secondary defenses or

Administer trimethoprim-sulfamethoxazole (Bactrim) as prescribed. Notify the physician if the child develops a cough or congestion.

The nurse is planning care for a school-age child admitted to the hospital with hemophilia. Which interventions should the nurse plan to implement for this child

The children should be carefully evaluated before giving live viral vaccines such as varicella, measles, mumps, and rubella.

The nurse is planning care for an adolescent with acquired immunodeficiency syndrome. The priority nursing goal is to: Prevent infection.

is to: Administer an antiemetic before chemotherapy begins.

The nurse is preparing a child for possible alopecia from chemotherapy. Which suggestion should be included in the teaching?Explaining to the child that, when hair regrows, it may have a slightly different color or texture.

A young child with leukemia has anorexia and severe stomatitis. The nurse should suggest that the parents try which intervention? Relax any eating pressures.

The school nurse is informed that a child with human immunodeficiency virus (HIV) will be attending school soon. Which is an important nursing intervention? Carefully follow universal precautions.

What is the priority nursing intervention for a child hospitalized with hemarthrosis resulting from hemophilia Immobilization and elevation of the affected joint

What is the most common mode of transmission of human immunodeficiency virus (HIV) in the pediatric population? Perinatal transmission

Which statement best explains why iron deficiency anemia is common during toddlerhood? Milk is a poor source of iron.

When teaching the mother of a 9-month-old infant about administering liquid iron preparations, the nurse should include that:Adequate dosage will turn the stools a tarry green color.

Children receiving long-term systemic corticosteroid therapy are most at risk for: Growth delays.

Which child should the nurse document as being anemic? 14-year-old child with a hemoglobin of 10 g/dL Anemia is defined as a hemoglobin level below 10 or 11 g/dL

The clinical features of sickle cell anemia are primarily the result of increased red blood cell destruction and obstruction caused by the sickle-shaped red blood cells

Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vaso-occlusive crisis?Painful swelling of hands and feet, painful joints

A common clinical manifestation of Hodgkin's disease is: Enlarged, firm, nontender lymph nodes.

Which condition is caused by a virus that primarily infects a specific subset of T lymphocytes, the CD4+ T-cells? Acquired immunodeficiency syndrome

immunosuppression Ineffective Protection related to thrombocytopenia Ineffective Tissue Perfusion related to anemia

Which home care instructions should the nurse provide to the parents of a child with acquired immunodeficiency syndrome (AIDS) Give supplemental vitamins as prescribed.

A young child with human immunodeficiency virus is receiving several antiretroviral drugs. The purpose of these drugs is to: Delay disease progression.

Which immunization should be given with caution to children infected with human immunodeficiency virus? Varicella

Golf Bowling Swimming

Which should the nurse teach about prevention of sickle cell crises to parents of a preschool child with sickle cell disease

Rarely cause addiction because they are medically indicated.

Which statement best describes B-thalassemia major Cooley's anemia?Increased incidence occurs in families of Mediterranean extraction.

A condition in which the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin is:Aplastic anemia.

Which statement most accurately describes the pathologic changes of sickle cell anemia?

The nurse is planning activity for a 4-year-old child with anemia. Which activity should the nurse plan for this child? Puppet play in the child's room

an important nursing responsibility is to assess the child's energy level and minimize excess demands

What is most descriptive of the pathophysiology of leukemia Unrestricted proliferation of immature white blood cells WBCs occurs.

boy with leukemia screams whenever he needs to be turned or moved. probable cause of this pain is invasion of the bone marrow with leukemic cells gradually causes a weakening of the bone and a tendency toward fractures

Which immunization should not be given to a child receiving chemotherapy for cancer? The vaccine used for measles, mumps, and rubella is a live virus and can result in an overwhelming infection

nurse is administering an intravenous chemotherapeutic agent to a child with leukemia. child suddenly begins to wheeze and have severe urticaria. Which is the most appropriate nursing action? STOP IT

Iron dextran is ordered for a young child with severe iron deficiency anemia. Nursing considerations include Injecting deeply into a large muscle.. Iron dextran is for intramuscular or intravenous administration

nurse is recommending how to prevent iron deficiency anemia in a healthy, term, breastfed infant. What should she or he suggest?Iron-fortified infant cereal can be introduced at approximately 6 months of age.

A school-age child is admitted in vaso-occlusive sickle cell crisis. The child's care should include:Adequate hydration and pain management.

parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. The nurse should explain that narcotic analgesics:

If a blood transfusion reaction of any type is suspected, stop the transfusion, take vital signs, maintain a patent IV line with normal saline and new tubing, notify the

practitioner, and do not restart the transfusion until the childs condition has been medically evaluated.

These manifestations are most suggestive of:Circulatory overload.The signs of circulatory overload include distended neck veins, hypertension, crackles, dry cough, cyanosis, and

precordial pain. Signs of air embolism are sudden difficulty breathing, sharp pain in the chest, and apprehension.

A child with leukemia is receiving triple intrathecal chemotherapy consisting of methotrexate, cytarabine, and hydrocortisone. The purpose of this is to prevent:Central nervous system disease.

young boy will receive a bone marrow transplant . This is possible because one of his older siblings is a histocompatible donor. This type of BMT is termed Allogeneic transplants from another individual