Slide 1
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PEDIATRIC CARDIAC & BLOOD
DISORDERS
Lecture 4b
Originated by: Susan Bruch, MSN
Revised by: Catherine Hrycyk, MScN
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Slide 2
HEART ATTACKS
should be treated
early. Say, 50 years
before they happen.
--- GE Healthcare
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Slide 3
DIET & EXERCISE
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Slide 4
KAWASAKI DISEASE (KD)
• Unknown etiology
• Most cases effect children < 5 years
• 1/5 of untreated cases result in severe cardiac
damage
• Causes inflammation of the vessels and can
lead to coronary artery aneurysms or ectasia
• Acute systemic vasculitis
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Slide 5
DIAGNOSTIC CRITERIA
Must exhibit 5 of 6:
1.
2.
3.
4.
5.
6.
*Temp > 5 days
Conjunctivitis (no d/c)
Oral mucous ∆’s
∆’s extremities
Multiform rash
Enlarged cervical lymph
nodes
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Slide 6
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Slide 7
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TREATMENT
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• High-dose IV gamma globulin
reduces coronary artery damage
• High-dose Salicylate therapy
1st : antipyretic/antiinflammatory
2nd : antiplatelet
• Symptomatic relief
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Slide 8
SICKLE CELL ANEMIA(SCA)
•
•
•
•
Hemoglobinopathies
Genetic
HbS: abnormal sickled hemoglobin
Sickle Cell Trait: HbA & HbS
Sickle Cell Anemia: mostly HbS
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Slide 9
SCA PATHWAY
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Slide 10
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SICKLED RBCs
•
Obstruction = clogging of RBCs in
ischemia & infarction of tissue
•
Destruction of RBCs hemolysis = anemia,
hypoxia, deoxygenation
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•
Gradual involvement of spleen, lungs,
kidneys, and brain
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vessels
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Slide 11
CLINICAL MANIFESTATIONS
GENERAL
 Delayed
growth &
development
 Chronic
anemia
 Prone to
sepsis
 Pallor
 Fatigue
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CRISIS
“pain episode”
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• Pain of involved
area/organ
• Enlargement and
dysfunction of organ
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Slide 12
INTERVENTIONS
• At Home
Avoid triggers of “pain episodes” (crisis)
Decreased ambient oxygen
Dehydration
• Hospitalized Child
Rest
Hydration O2 prn Abx prn
Electrolyte replacement Pain control
Blood transfusions prn
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Slide 13
ACUTE LYMPHOBLASTIC LEUKEMIA
(ALL)
 Immature WBCs = infection
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 RBCs = anemia
Platelets = bleeding
Bone Pain
Possible Fractures
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Hepatosplenomegaly
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Slide 14
ACUTE LEUKEMIA
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Slide 15
Dx / Eval
Hx S/S CBC
Peripheral blood
smear
**Bone marrow
biopsy
Lumbar Puncture
Treatment
Chemotherapy
Pain control
Prevent / treat
infection
 Protein diet
Support
Teach
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