What should the discharge plan for a school-age child with sickle ...

[jilianpiloj]

What should the discharge plan for a school-age child with sickle cell disease include?
 
  a. Restricting the child's participation in outside activities
  b. Administering aspirin for pain or fever
  c. Limiting the child's interaction with peers
  d. Administering penicillin daily as ordered

Question 2

A child with sickle cell disease is seen in the emergency department with increasing back and leg pain for the past 2 days. What is this child most likely experiencing?
 
  a. A vaso-occlusive crisis
  b. Acute splenic sequestration
  c. Erythroblastopenia
  d. Acute chest syndrome

[josephsuarez]

Answer to Question 1

D
Children with sickle cell disease are at a high risk for pneumococcal infections and should receive long-term penicillin therapy and preventive immunizations. Sickle cell disease does not prohibit the child from outdoor play. Active and passive exercises help promote circulation. Aspirin use should be avoided. Acetaminophen or ibuprofen should be administered for fever or pain. The child needs to interact with peers to meet his developmental needs.

Answer to Question 2

A
A vaso-occlusive crisis is the most common type of crisis and is characterized by mild to severe pain. Pain can occur anywhere, but is typically manifested as bone or joint pain. Symptoms of acute splenic sequestration are associated with blood volume pooling, causing splenic enlargement and hypovolemic shock. Symptoms of pallor, lethargy, headache, and upper respiratory infection seen in erythroblastopenia result from decreased blood cell production by the bone marrow. Chest pain, fever, and cough are characteristic of acute chest syndrome.