Reference no: EM133768376

Question

Assessment Signs of changes in the hematologic system are often insidious and overlooked. Children with cancer often demonstrate similar signs. Skin color changes such as pallor, bruising, and flushing are often the first signs that a problem is developing. Changes in mental status such as lethargy can indicate a decrease in Hgb and a decreased amount of oxygen being delivered to the brain. Nursing assessment must include a thorough approach. Health History Elicit the birth and maternal history, noting low birth weight or gestational diabetes and ascertaining whether vitamin K was given after birth. The past medical history might be significant for recent illnesses that may contribute to a change in blood cell distribution. Determine the child's sleep/wake patterns and bowel elimination patterns, which may be affected by alterations in circulating blood volume or changes in oxygenation. Explore the family history for inherited disorders such as hemophilia, sickle cell disease, thalassemia, or history of cancer. Determine the presence of risk factors such as previous malignancy and treatment; synthetic chemical exposures; parental exposure to radiation, chemicals, or chemotherapeutic agents; and a family history of malignancy (especially childhood), immune disorders, or genetic disorders such as neurofibromatosis or Down syndrome. Evaluate the child's.