Question

Case Study #7

H.M. is a 15-year-old African American adolescent who was diagnosed with sickle cell disease three years ago. H.M. presents to the emergency department with pain related to sickle cell crisis.

Subjective Data

Pain level is an 8/10 location = bilateral legs, described as deep muscle pain

Student in 10th grade, honor roll student

On the track team

Lives with mother and father

Objective Data

Vital signs: T= 99.3 P= 80 R= 18 BP= 140/68

Weight: 140 lbs

HT: 5 feet, 6 inches

Questions (10 points total)

1. What other assessments should be included for this patient? (2 points)

2. What type of pain is this patient experiencing? (2 points)

3. What standards of assessing pain will be applied to this patient’s plan of care? (2 points)

4. What teaching should the nurse consider from the problems list? (2 points)

5. What interventions should be included in the plan of care for this patient? (2 points)

Answer 1

ASSESSMENTS FOR THIS PATIENT- ® General Examination :- O PALLOR @ ICTERUS © CLUBBING CYANOSIS PEDAL EDEMA * LOCAL EXAMINATION :- CVS - O INSPECTION , © PERCUSSION; © ASCULTATION -S, S2 Sounds Abdomen - OINSPECTION © PALPATION - HEPATO SPLENOMEGALY-2 © PERCUSSION O INSPECTION AUSCULTATION - NORMAL VESICULAR BREATH SOUNDS * PERCUSSION INVESTIGATIONS- Hemoglobin pocentage & Complete blood count © DLC If acterus Ave © ESR LiveP FUNCTION ② Reral Function Test URINE ANALYSIS Specific chest x-ray Bone marrow aspiration TEST

③ TUPE OF PAIN :- ACUTE PAIN. (THROBBING TYPE'). This as due to tissue infraction. © The tissues are skeletal tissue or soft tissue ® They are sudden onset. Due to sickling the RBC gets clogged in the small vessels and causes infraction. @ PAIN ASSESSMENTS- O Intensity of pain with behavioural and associated anzciety of the patient should be assessed. Some of the tools for assesment of the pain are - o verbal rating & Visual analogue ③ numerical nating @ Computer graphic These are scales fou pain.

© Behavioural pain scales © McGill pain questionnabe © Porn and ampaisiment relationship scales onset, intensity , duration, location , radiation , time of pain in history asked.

PLAN OF CARE : O CORRECT THE IMPAIRED GAS EXCHANGE for the connection of defeat oxygen CORRET THE FLUID VOLUME IN PATIENT ③ RELIEVE THE PAIN medications alternate pain relieving strategies. OTO MAINTAIN SKI INTEGRITY PREVENTION OF INFECTION Due to empaired gas exchange, tissue perfusion is reduced so it is important to CORRECT TISSUE PERFUSION
The assessment

type of pain

assessment of pain

Interventions are described