Fever and Neutropenia
The initial workup, including lab collection and antibiotic administration, should all be completed within this amount of time.
1 hour
This provider group should be contacted for patients who present with fever and sickle cell disease.
True or False: Restraints are the FIRST option to promote safety in patients who are escalating.
False
A minimum of _____ nurse(s) should be assigned to formal trauma cases
2
True or False: Pre-administration blood product checks require only one nurse.
False - pre-administration checks, including administration rights, patient verification, and math should be completed with two RN's
This medication AND weight based dose is the first line antibiotic for patients with fever and neutropenia
50mg/kg Cefepime
A patient with sickle cell disease who presents with fevers would be assigned this acuity score.
Acuity 2
2
Primary Survey includes:
Airway
Breathing
Circulation
Disability
Exposure
This amount of blood should be administered over the first 15 min.
5% of total volume or 15cc, whichever is less for pediatric patients under 40kg.
Assess for initial transfusion reactions.
Describe the process of port access.
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According to the Management of Febrile Illness in Children with Sickle Cell Disease Algorithm, this medication AND dose should be given after lab collection when a pt presents with fever and sickle cell disease
50mg/kg Ceftriaxone
This age range requires restraint orders to be renewed every 2 hours.
9-17 years old
16 years old- Anyone 16 or older is considered an adult trauma patient.
Give three common blood transfusion reactions AND what to do if symptoms occur.
Pulse change
BP change
Hives/rash
Fever/chills
"Impending doom" feeling
Respiratory symptoms
What are the VS expectations for patients with fever and neutropenia?
Q15 min for first hour after abx
Q30 minutes for 2nd hour after abx
Q2 hours (per PEDS ED policy) after 2nd hour.
These immature red blood cells can be produced by your body and delivered into the blood stream prematurely in the presence of anemia.
Reticulocytes
This "dot phrase" note is required when initiating restraints.
.PEDSVIOLENTRESTRAINT
This member of the healthcare team is responsible for activating ALL traumas
(Policy 13184330)
30 min.
The RN should be prepared to give the blood within 30 min of the blood arriving to the unit. If the RN is not ready to administer blood, he/she should wait to "release" the order in the patients chart.
Describe the pathophysiology of bacterial cell lysis AND potential associated clinical manifestations.
Antibiotics meet and interact with the bacteria. Antibiotics disturb balance of bacteria cell and begin to break down bacterial cell wall. The bacteria will begin to swell and eventually break down. This can cause an acute decompensation of the patient - presentation includes hypotension, poor color, altered mental status, VS changes, SIRS/sepsis presentation.
Describe the pathophysiology of a splenic sequestration in a sickle cell patient.
RBC's captured in the spleen
Spleen becomes acutely and progressively enlarged
Acute drop in hemoglobin despite persistent reticulocytes production
Can lead to hypovolemia and shock
Require prompt blood admin
1 hour
Name three of five pediatric trauma attendings at URMC
Wakeman, Arca, Pegoli, Darcy, Wilson.
What is the extension to 7N, a great unit to use as a resource for blood/blood product administration.
x54831