Question

Roslyn is complaining of severe pain. She is 6 years old and has been placed in public school for the first time. Now she is complaining of her legs hurting. She is so excited about being in school finally, but her parents report that she is not participating in play time, seems weaker, and is pale. She is diagnosed with sickle cell anemia, parents undergo genetic testing as well as all her siblings, and it is found that she is the only child with the disease.

Provide nursing diagnosis and nursing interventions for this child. What is your priority nursing care?

Answer 1

ANSWER

Nursing diagnosis for Roslyn with sickle cell anemia.

           * Acute pain related to agglutination of sickle cells within the blood vessel.

           * Risk of powerlessness related to disease induced helplessness.

           * Deficient knowledge regarding prevention of the illness.

Nursing intervention.

          * Management of acute pain.

                       * Assess the pain level using a pain scale and give analgesics as

                         as per physicians order.

                       * Support and elevate swollen joints untill the swelling diminishes.

                       * Educate about relaxation techniques,breathing exercises and distraction

                          to ease pain.

                       * TENS(transcutaneous nerve stimulation),physiotherapy and whirlpool baths

                          are also used to control pain.

            * Management of fatigue.

                       * Give enough fluids if she shows signs of dehydration.

                       * Assess the intake and output chart and encourage her to take

                         adequate food.

                       * Allow enough resting hours and provide a peaceful environment

                         to reduce stress and weakness.

                      * Give vitamin supplements if required as per physicians order.

   Increasing knowledge level.

* Educate the patient about situation which can precipitate a sickle cell

crisis and methods used to prevent such situation like

   * Keep the patient warm.

   * Maintain adequate hydration.

   * Avoid stressful situations.

                                                 * Protect the leg from trauma and infections by hygienic

                                                   practices and avoiding overstraining exercises.

                                               * If any emergency situation or problem occur seek immediate

                                                   medical care.

* Priority nursing care for her is management of acute pain due to sickle cell anemia.