Heme-Onc Flashcards
What is the parent education for iron administration?
-Given with OJ (Vitamin C containing drink) between meals, don’t give with milk products
-Expect green, tarry stools
-If n&v, give with meals
-May stain teeth – give in syringe in back of mouth, brush after
What are the symptoms of vaso-occlusive crisis in sickle cell disease?
-Pain in areas of involvement, r/t ischemia of involved areas
-Extremities – painful swelling of hands and feet, painful joints
-Abdomen – severe pain
-Cerebrum – stroke, visual disturbances
-Chest – pneumonia, protracted pulmonary disease
-Liver – obstructive jaundice
-Kidney – hematuria
-Genitalia - priapism
What is the purpose of daily penicillin for children with sickle cell disease?
Oral penicillin prophylaxis- significantly reduces risk of pneumococcal infection
What are critical complications of sickle cell disease?
(Splenic) Sequestration: Pooling of a large amount of blood usually in the spleen
Acute Chest Syndrome: Similar to pneumonia - presence of a new infiltrate.
Chest pain, fever, cough, tachypnea, wheezing, hypoxia
Cerebrovascular Accident (Stroke): Sudden, severe, cerebral infarction caused by sickled cells
What are preventative measures for children with sickle cell disease?
Prevent precipitating factors:
-Anything that increases body’s need for oxygen or alters the transport of oxygen
-Trauma
-Fever, infection
-Physical and emotional stress
-Increased viscosity due to dehydration
-Hypoxia
-Results from high altitude, poorly pressurized airplanes, hypoventilation, vasoconstriction due to hypothermia
Family education and support:
-Medications
-Prevention
-Recognize signs and symptoms of stroke & splenic sequestration
-Normalize ☺
What vaccines should be given with caution for children with HIV?
MMR, varicella, rota
What is the care for a child with mucositis?
-Frequent oral care
-Inspect mouth for ulceration and hemorrhage
-Soft bristled brush
-Mouthwashes (baking soda/salt/ water, Hibiclens): ”swish and swallow”, “swish and spit”
-Bland, moist soft diet
NO:
-Viscous lidocaine
-Lemon-glycerin swabs
-Hydrogen peroxide
-Milk of magnesia
What are signs and symptoms of cancer in children?
-Unusual mass or swelling
-Unexplained paleness and loss of energy
-Sudden tendency to bruise
-Persistent, localized pain or limping
-Prolonged, unexplained fever or illness
-Frequent headaches, often with vomiting
-Sudden eye or vision changes
-Excessive, rapid weight loss
