NU 246 (EXAM 2)-HEMOPHILIA
Terms
undefined, object
copy deck
-
PROPHYLACTIC THERAPY IS USED TO__
-STARTED AT AGE__
-FACTOR GIVEN__ -
TO KEEP FACTOR LEVEL > 1
-START AT AGE 1-2 YRS
-FACTOR VIII TIW
-FACTOR IX BIW
-IVAD - PT SHOULD BE VACCINATED AGAINST__
-
1.HEPATITIS B
2.PT STILL AT RISK FOR HEP C - OTHER NSG MEASURES FOR HEMOPHILIA
-
-NO IM (ONLY SUB Q)
-GOOD DENTAL CARE
-CHECK TYPE OF SHOES
-MED ALERT ID
1.COSTLY DISEASE
2.NEED COMPREHENSIVE TEAM APPROACH
3.GENETIC COUNSELING
4.GENE THERAPY IN PROCESS
5.PROPHYLACTIC THERAPY - NSG PLAN/IMPLEMENT FOR HEMOPHILIA
-
A.GROWTH AND DEVELOPMENT
-AVOID OVERPROTECTING
-ALLOW CHILD TO RUN,EXPLORE,CLIMB
-NEED REGULAR PROGRAM OF EXERCISE,SELF ESTEEM
B.BLEEDING EPISODE
-ADMINISTER**FACTOR A OR B CONCENTRATE IV (AHF=ANTIHEMOPHILIC FACTOR)
-(9-12 YRS OLD=SELF ADMINISTRATION)
-**CRYOPRECIPITATE NO LONGER RECOMMEND - NURSING FOR MINOR CUT
-
TREAT SAME AS WOULD FOR ANYONE ELSE
-APPLY PRESSURE Q 10-15 MIN
-INCREASE EXTREMITY
-IMMOBILIZE
-COLD PACKS - NSG DIAGNOSIS FOR HEMOPHILIA
-
1.RISK FOR INJURY
2.KNOWLEDGE DEFICIT
3.INEFFECTIVE COPING - LAB TEST
-
1.STAGE 1 (PTT)
CHECK HEPARIN
2.STAGE 2 (PT)
CHECK COUMADIN
FACTOR ASSAY PROCEDURE - IF HEMOPHILIA MILD,DIAGNOSE__
- DELAYED, POST-OP
- IF HEMOPHILIA SEVERE,DIAGNOSIS MADE DURING __
- INFANT/TODDLER
-
ASSESSMENT
HISTORY
P.E. -
HISTORY-HEMOPHILIA IS A GENETIC D/O
FAMILY HISTORY
HISTORY OF PROLONGED BLEEDING
P.E.:1.VS,SKIN COLOR,TEMP,DYSPNEA
2.JOINT SWELLING
3.BRUISES - MAJOR CONCERN
-
HEMARTHROSIS(BLEEDING IN THE JOINTS)
S/S:TINGLING,BUBBLING SENSATION,CAN BE SPONTANEOUS JOILT TWIST
-JOINT WILL BE DAMAGED AND SURGERY NEEDED.JOINT WILL SWELL W/BLD AND GET STIFF.TISSUE WILL BE DESTROYED-->ANKYLOSIS - HEMARTHROSIS CAN LEAD TO__
- ANKYLOSIS
- SEVERITY OF HEMOPHILIA DEPENDENT ON__
- AMT OF FACTOR PRESENT
- CHRISTMAS DISEASE
-
FACTOR IX IS DEFICIENT
AKA: HEMOPHILIA B
-AFFECTS 2ND PHASE OF 1ST STAGE IN COAGULATION PROCESS(THROMBOPLASTIN) - WHAT SHOULD PT BE CONCERNED W/ HEMOPHILIA
- INTERNAL BLEEDING
- WHAT HAPPENS TO BLEEDING W/ HEMOPHILIA
-
BLEEDING IS PROLONGED
WHY?BECAUSE NO CLOTTING FACTOR
NOT:EXCESSIVE BLEEDING,NOT PROFUSE BLEEDING,NOT FASTER BLEEDING - CLASSIC HEMOPHILIA
-
FACOR VIII IS DEFICIENT
AKA: HEMOPHILIA A - VON WILLEBRAND
- MALE AND FEMALE
- HEMOPHILIA
-
INHERITED D/O OF BLOOD CLOTTING
- X LINKED RECESSIVE=MALE
- CARRIERS FEMALE=ASYMPTOMATIC