30- sickle cell Flashcards
two most common surgeries for someone with sickle cell disease
tonsillectomy- lymphoid hypertrophy–> apnea
cholecystecomy- increased RBC breakdown–>gallstones
why is penicillin given daily to sickle cell disease pts until age 5-6?
prevent sepsis of encapsulated organisms- no splenic function
what should you do if sickle cell disease child gets fever?
medical emergency- blood cultures and broad spectrum antibiotics, watch for 48-72 hrs
check up for sickle cell disease child
- jaundice signs
- stroke signs (asymmetrical weakness)- transcranial doppler
- anemia- paleness, fatigue
-respiratory problems (tachynpnea, chest pain)-
pneumonia or vasoocclusive
- injuries
- transfusion history
- priapism
what extra vaccines do sickle cell dis patients get
meningococcal
23 valent pneumococcal polysaccharide vaccine
differential for sickle cell kid with fever, respiratory distress, and chest pain.
- Acute chest syndrome (vasocclusive)
- pericarditis
- CHF
- rib infarction
- sepsis
indications for RBC transfusion in child with sickle cell
worsening chest symptoms
increased resp rate
progressive infiltrates on cxr
declining o2 stats
falling hgb
treatments for severe sickle cell disease
stem cell transplants
hydroxyurea
causes of acute chest syndrome
infection,
pulmonary fat embolism,
intrapulmonary sickling
CXR for acute chest syndrome
Multilobar infiltrates (more commonly lower and middle lobes)
Effusions
Atelectasis
pericarditis on CXR
infiltrate and effusion
CHF on CXR
Lower lobe infiltrates and cardiomegaly
when to seek care for child with sickle cell
Fever splenic enlargement slurred speech- stroke Chest pain rapid breathing increased pallor- splenic, hemolysis, aplastic crisis increased jaundice- hemolysis priapism
