Running Head: CARDIOVASCULAR AND HEMATOLOGIC DISORDERS IN CHILDREN 1

Cardiovascular and Hematologic Disorders in Children

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CARDIOVASCULAR AND HEMATOLOGIC DISORDERS IN CHILDREN 2

Cardiovascular and Hematologic Disorders in Children

How would you evaluate and manage a pediatric patient who has a painful swelling of the

hands and feet, fatigue, or fussiness? Which diagnostic studies would you recommend for

this patient and why?

Painful swelling of the feet and hand could lead to a diagnosis of several pediatric diseases. In

this case (pediatric patient), it is important for the healthcare provider to differentiate between

general and specific symptoms. Fussiness and fatigue are classified as general symptoms because

they tend to exist in several conditions. Unlike fussiness and fatigue, painful swelling of the feet

and hand are specific symptoms, which must be prioritized during the diagnosis of the pediatric

patient. According to some researches, pediatric patients that experience painful and tender joints

might be as a result of medical conditions such as trauma, hemoglobinopathies, Henoch-

Schoenlein purpura, Lyme disease, systemic lupus erythematosus, and tumors infection

(McCance & In Huether, 2019). On the other hand, asymmetrical severe swelling may likely

point to sickle cell. Swelling of the joints may be a result of joint effusion, sprain, synovitis,

rheumatoid, or torn meniscus.

Due to the several differential diagnosis, further tests are essential in order to establish

accurate diagnosis. It is important to note that these diagnosis include should include

Complete Blood Count (CBC) with differential, reticulocyte count, peripheral blood smear,

and an X-ray of the affected feet and hands.

The CBC with differential will help in giving some understanding if there should arise an

occurrence of the presence of disease dependent on the quantity of white blood cells or any

variations from the norm, sickliness dependent on the hematocrit and hemoglobin levels, or
CARDIOVASCULAR AND HEMATOLOGIC DISORDERS IN CHILDREN 3

draining issue dependent on the blood check. The hemoglobin electrophoresis is basic in the

recognizable proof of any hematologic pathology. A reticulocyte include is significant in

assessing the bone marrow working, as the c-responsive protein and erythrocyte sedimentation

rate are incendiary markers (Al-Salem, 2016). The liver function test will enable the doctor to

see whether the liver is related with the patient's symptoms or malfunctions. The peripheral

blood spreads are fundamental in assessing the general blood irregularities. To preclude injury or

injury, a x-beam of the influenced territory is required. The administration will rely upon the

discoveries of the above tests, after which a treatment plan will be given dependent on the

conclusion.

What physical exam findings and diagnostic results would be concerning to you and why?

What would be three differentials in this case?

In provided case of the pediatric patient, the physical assessment discoveries that are of

significance incorporate systolic murmurs, swelling and warmth of the right foot and left hand

(dactylitis), the antalgic gait, abdominal tenderness and distention, and splenomegaly. These

discoveries are significant since the patient is associated with having a sickle cell emergency.

The sickle cell illness is a hereditary problem described by variations from the norm in the

oxygen-conveying hemoglobin particles in the red platelets. There are a few regular muscular

intricacies of sickle cell sickness, for example, Dactylitis, Leg ulcer, Osteoporosis, and vertebral

breakdown, Avascular putrefaction of the hip, Pathological crack, Arthritis, Growth impediment,

and skeletal adolescence, Osteomyelitis, Septic joint inflammation (Al-Salem, 2016).

Nonetheless, in light of the introducing sign and manifestations, Mia may be experiencing any of

the accompanying 3 differential diagnosis: psoriatic joint inflammation since it additionally gives
CARDIOVASCULAR AND HEMATOLOGIC DISORDERS IN CHILDREN 4

dactylitis; septic joint pain which also leads to joint growing and agony; adolescent rheumatoid

joint pain which likewise gives joint torment (Abdelgawad, and In Naga, 2014).

What are your final assessments (diagnoses) for this patient? What is your treatment

recommendation and education for the patient and family? Why?

In pediatric patients with sickle cell ailment, the main source of death is an intrusive bacterial

disease. Various diseases can cause demise because of an undermined resistant framework

because of spleen brokenness, henceforth the requirement for anti-infection prophylaxis to

forestall this danger. All the patients from 2 months to 5 years ought to be given penicillin, after

which proof based exploration shows that there are no clinical advantages in proceeding with the

utilization of the anti-infection routine (Lewis, 2015). As per pediatric clinical practice rule for

the administration of SCD, children between 2 months to 3 years are managed with 125mg

penicillin, two times per day while the individuals who are between 3 to 5 years are given 250mg

penicillin two times every day. The suitable family instruction will remember more accentuation

for the severe of the dangers that are related with bacterial contamination, the casualty rate

related with meningitis and septicemia, significance of keeping the patient hydrated, how to

dodge hypoxic express that is related with effort, significance of the patient being inoculated

particularly for Streptococcus pneumoniae, and when to look for clinical consideration

particularly when the fever of the patient is 101.3°F or 38.5°C because of the danger of cutting

off disease. The family ought to likewise be taught on keeping up high hand cleanliness when

dealing with the patient to forestall contaminations.

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References

Abdelgawad, A., & In Naga, O. (2014). Pediatric Orthopedics: A handbook for primary care

physicians. New York: Springer

Al-Salem, Ahmed. (2016). Medical and Surgical Complications of Sickle Cell Anemia. Springer

International Publishing.

Chakravorty, S., & Williams, T. N. (January 01, 2015). Sickle cell disease: a neglected chronic

disease of increasing global health importance. Archives of Disease in Childhood, 100, 1,

48-53.

Lewis, M. E. (2015). Sickle cell disease: Genetics, management, and prognosis. New York: Nova

Biomedical.