Brittany Long is a 5-year-old African American female with ahistory of sickle cell anemia (HbSS) treated with regular folicacid supplement who came in yesterday with an acute vaso-occlusivepain crisis. Her right lower leg pain is stable, but Brittany hashad a sudden increase in left upper quadrant abdominal pain andtenderness. Her spleen is palpated 3 cm below the left costalmargin. She rated her abdominal pain a 5 on the FACES Scale andreceived morphine sulfate. She continues to receive intravenousmaintenance fluids at 52 mL/hr and is on a nasal cannula withoxygen 2 L/min. She is pale and weak and just wants to sleep. Hermother is concerned about her increasing fatigue. Her urinaryoutput is decreased, and she no longer wants to take fluids bymouth, not even for mom. Her vital signs have been taken every 2hours, and she had labs drawn twice. Her last hemoglobin wasdecreased by 1.3 g/dL, and is now 7.5 g/dL; platelets are alsodecreasing and are 200; her reticulocyte count is increasing and is7.5. Legal consent to give blood products has been obtained fromthe mother.
Pediatric Nursing Care
Tagher, C. G., and Knapp, L. M. (2020). PediatricNursing: A Case-Based Approach.
- Natasha Austin: Sickle Cell Anemia, Chapter 12, pp.138-155
- Sickle Cell Disease, Chapter 25, pp. 497-503
- The Pharmacy 12.1, Medications Used in the Treatment of SickleCell Anemia, p. 140
- The Pharmacy 12.2, Medications used in the Treatment of SickleCell Crisis, pp. 146-147
- The Pharmacy 25.1, Hydroxyurea, p. 501
- The Pharmacy 25.2, Deferoxamine, p. 502
- The Pharmacy 25.3, Deferasirox, p. 506
- The Pharmacy 25.4, Factor VIII, p. 511
- The Pharmacy 25.5, Desmopressin, p. 512
- Table 12.1, Natasha’s Laboratory Test Results, Chapter 12, p.148
- Box 25.1, Diagnostic Test for Sickle Cell Disease, Chapter 25,p. 500
- At the Hospital, Chapter 12, pp. 144-154
- Therapeutic Interventions, Chapter 25, pp. 500-502
- How Much Does It Hurt? 12.1, Assessing Natasha’s Pain Using theNumeric Rating Scale, Chapter 12, p. 146
- Pain Assessment, Chapter 17, pp. 227-228
- How Much Does It Hurt? 25.1, Pain Management DuringVasoocclusive Crisis, Chapter 25, p. 501
- Developmental Theories, Chapter 17, pp. 229-230
- Pediatric Assessment in an Emergency, Chapter 34, pp.708-710
- Shock, Chapter 34, pp. 715-719
Diagnostic Tests
Expert Clinical Content from Lippincott Advisor
- Red Blood Cell Count
Pharmacology
Expert Clinical Content from Lippincott Advisor
- Morphine
- Ketorolac tromethamine
- Folic acid
- Sodium chloride
Procedures
Expert Clinical Content from Lippincott Procedures
Blood and Blood Product Transfusion, Pediatric
- 1. Document your initial focused assessment of BrittanyLong.
- 2. Identify and document key nursing diagnoses for BrittanyLong.
- 3. Referring to your feedback log, document the nursing careyou provided and Brittany Long’s response.
- 4. Document the patient teaching that you would provide forBrittany Long and her family before discharge.
- 5. Document your handoff report in thesituation-background-assessment-recommendation (SBAR) format tocommunicate what further care Brittany Long needs.
