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Nursing management of pediatrics blood disorders - Coggle Diagram
Nursing management of pediatrics blood disorders
1. Introduction to Anemia
Definition
: Reduction in RBCs or Hb below normal for age.
Classifications:
Morphologic (Size/Shape/Color):
-Microcytic (Iron deficiency, Thalassemia)
-Normocytic (Acute blood loss)
-Macrocytic (B12/Folate deficiency)
Etiologic:
-
Decreased Production
(Bone marrow failure, nutritional deficits).
-
Increased Destruction
(Hemolysis: Corpuscular/Extracorpuscular).
-
Blood Loss
(Acute/chronic hemorrhage).
Common Causes in Egypt:
-Neonates: Hemolytic disease (Rh/ABO), hemorrhage.
-Infants/Children: Iron deficiency, G6PD deficiency, Thalassemia.
2. Iron Deficiency Anemia (IDA)
Causes:
-Inadequate intake (excessive milk, delayed solids).
-Poor maternal stores (prematurity, maternal anemia).
-Blood loss (hookworm, menstruation).
Pathogenesis:
↓ Iron stores → ↓ Ferritin → ↑ TIBC → Microcytic, hypochromic RBCs.
Clinical Features:
Pallor, fatigue, pica, spoon-shaped nails (koilonychia).
CNS
: Poor attention, learning delays.
Diagnostics:
Labs: ↓ Hb, ↓ MCV, ↓ Serum iron, ↑ TIBC, ↓ Ferritin.
Stool occult blood
(rule out bleeding).
Management:
-Prevention
: Breastfeeding, iron-fortified formula (1–2 mg/kg/day for preterms).
-Treatment:
1-Oral iron (3–5 mg/kg/day elemental iron + Vitamin C).
2-SE
: Black stools, GI upset.
3-IV iron/transfusion (severe cases).
Nursing Care:
-Administer iron between meals.
-Use straw/dropper to avoid tooth staining.
-Educate on iron-rich foods (meat, beans, greens).
3. Sickle Cell Anemia (SCA)
Pathophysiology:
HbS
polymerizes under hypoxia → Sickling → Vaso-occlusion → Tissue ischemia.
Clinical Features:
1-Chronic Hemolysis:
Jaundice, gallstones.
2-Crises:
-Vaso-occlusive
: Pain (dactylitis, acute chest syndrome).
-Splenic Sequestration
: Hypovolemic shock.
-Aplastic
: Parvovirus-induced RBC suppression.
Diagnostics:
Sickledex
(screening) →
Hb electrophoresis
(confirmatory).
Management:
1-Hydration, Oxygen, Pain control
(morphine).
2-Transfusions
(acute chest, stroke risk).
3-Hydroxyurea
(↑ HbF).
4-BMT
(curative).
Nursing:
1-Monitor for
stroke
(focal weakness, seizures).
2-Prevent infection (penicillin prophylaxis, vaccines).
4. β-Thalassemia Major (Cooley’s Anemia)
Pathophysiology:
↓ β-globin chains → Unstable Hb → Hemolysis →
Ineffective erythropoiesis
.
Iron overload
from transfusions → Hemosiderosis (organ damage).
Clinical Features:
1-Thalassemic Facies
: Frontal bossing, maxillary hyperplasia.
2-Growth retardation
, Hepatosplenomegaly.
3-Complications:
-Cardiac failure (iron-induced cardiomyopathy).
-Endocrine dysfunction (diabetes, hypothyroidism).
Diagnostics:
-Hb electrophoresis
: ↑ HbF, ↓ HbA.
-MRI
(liver/heart iron quantification).
Management:
-Chronic Transfusions
(maintain Hb >9.5 g/dL).
-Iron Chelation
(Deferoxamine/Deferasirox).
-Splenectomy
(if hypersplenism).
Nursing:
-Monitor for
transfusion reactions.
-Educate on
chelation therapy
(SC/IV routes).