HEME ONC CLASS MATERIALS

Question 1

What interventions would be appropriate for a child with ALL on chemotherapy who presents to the ER with fever, redness at port site, purpura or bruising, sore throat, mucositis, coughing.

Answer 1

1. Admit to ped onc w/ neutropenic precautions: immunocompromised pt w/ low neutrophil count.
2. VS - probably on continuous montinors.
3. fluids
4. blood culture from central line
5. Abx, broad spectrum ie. ceftriaxone, maybe more than 1, could use bactrim (trimethoprim/sulfamethoxazole)
6. throat swab
7. manage pain - morphine
8. nystatin oral wash
9. no mouthwash w/alcohol or anything drying. more likely to use saline or baking soda and water