Chapter 20: Hematological, Immunological & Neoplastic Disorders

Hematological, Immunological & Neoplastic Disorders begins by exploring hematological dysfunctions, including the pathophysiology and management of iron deficiency anemia, often caused by dietary factors, and sickle cell disease, a genetic hemoglobinopathy characterized by vasoocclusive crises and chronic pain. The text details the nursing care for children with aplastic anemia, which involves pancytopenia and may require hematopoietic stem cell transplantation (HSCT), as well as clotting disorders like hemophilia and immune thrombocytopenia (ITP) that necessitate careful bleeding precautions and factor replacement therapy. Significant attention is given to lead poisoning prevention and treatment, alongside the safe administration of blood transfusions. The immunological section focuses on HIV/AIDS in the pediatric population, discussing vertical transmission, antiretroviral therapy, and the prevention of opportunistic infections. The chapter then transitions to oncological disorders, providing in-depth coverage of common pediatric cancers such as leukemia (acute lymphocytic and myeloblastic), lymphomas (Hodgkin’s and non-Hodgkin’s), brain tumors like medulloblastoma and astrocytoma, and renal malignancies like Wilms’ tumor. It outlines the multifaceted treatment modalities including chemotherapy protocols, radiation therapy side effects, and biological response modifiers. Throughout, the summary highlights essential nursing roles in infection control for neutropenic patients, pain management, nutritional support, palliative care, and the psychosocial support of families navigating life-threatening illnesses.