Chapter 48: Hematologic & Immunologic Disorders in Children

Hematologic & Immunologic Disorders in Children begins with a deep dive into red blood cell conditions, primarily focusing on anemia, which reduces the blood’s ability to transport oxygen and often leads to clinical signs like pallor and lethargy. A significant portion is dedicated to iron-deficiency anemia, highlighting its prevalence in specific Canadian demographics and the necessity of nutritional counseling alongside iron therapy. The text also contrasts complex hereditary disorders such as sickle cell anemia, known for its painful vaso-occlusive episodes and potential for acute chest syndrome, with beta thalassemia, which requires rigorous transfusion schedules and chelation to prevent organ damage from iron deposits. Disorders of the bone marrow, such as aplastic anemia, are presented as life-threatening states of pancytopenia that often necessitate hematopoietic stem cell transplantation or intensive immunosuppression. In terms of hemostasis, the chapter outlines the management of bleeding disorders like hemophilia and immune thrombocytopenia, stressing the importance of injury prevention, factor replacement, and the use of the PRICE (Protection, Rest, Ice, Compression, Elevation) method during acute episodes. The discussion on pediatric oncology covers the most common cancers in children, including leukemia and lymphoma, where nurses must meticulously manage the complications of chemotherapy, such as infection risk from neutropenia, mucosal damage, and psychological impacts like alopecia. Additionally, the text covers primary and acquired immunodeficiencies, including the chronic care for children living with HIV and AIDS and the specialized isolation required for infants with severe combined immunodeficiency (SCID). The chapter concludes with the technical aspects of blood product administration, the importance of HLA compatibility in preventing graft-versus-host disease during transplants, and the therapeutic applications of apheresis for component separation.