A nurse is creating a plan of care for a child who has sickle cell

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Nursing Care of Children 2

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Please upgrade to Cram Premium to create hundreds of folders! A nurse is reinforcing teaching with a group of parents of toddlers about growth and development. Toddlers are not growing as rapidly as they did in infancy, and weight gain does not cause a protruding abdomen.

a nurse is creating a plan of care for a child who has sickle cell

The abdominal muscles are immature and not well developed at this stage. Therefore, it is common for a toddler to have a "potbellied" appearance. A nurse is caring for a child who has an exacerbation of cystic fibrosis. Which of the following laboratory findings should the nurse report to the provider immediately?

The nurse should apply the ABC priority-setting framework. This framework emphasizes the basic core of human functioning — having an open airway, being able to breathe in adequate amounts of oxygen, and circulating oxygen to the body's organs via the blood. When applying the ABC priority-setting framework, airway is always the highest priority because the airway must be clear and open for oxygen exchange to occur. Breathing is the second-highest priority in the ABC priority-setting framework because adequate ventilatory effort is essential in order for oxygen exchange to occur.

Circulation is the third-highest priority in the ABC priority-setting framework because delivery of oxygen to critical organs only occurs if the heart and blood vessels are capable of efficiently carrying oxygen to them. Therefore, the nurse should report this finding to the provider immediately. An RBC of 3. A school nurse is collecting data from an adolescent child who returned to school following a case of mononucleosis.

The child has a note from his provider excusing him from gym class. Which of the following findings should the nurse identify as the reason for this excusal?

An adolescent who has mononucleosis will have lymphadenopathy and often splenomegaly, which can persist for many months. For this reason, even after the adolescent is able to maintain his usual energy level and return to school, it is important for him to avoid activities that might result in trauma to the enlarged spleen.

Although an adolescent who has mononucleosis might have difficulty swallowing in the early phases of the illness, upon his return to school, he should not have deficient dietary intake. Epstein-Barr virus causes mononucleosis and is spread primarily through direct contact with the saliva of an infected individual. Casual contact during gym and recess would be no more hazardous than having the child in a classroom. An adolescent who has mononucleosis will not have joint inflammation.

A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions should the nurse take? Provide the child with a low carbohydrate diet. Glomerulonephritis does not require strict bed rest, because ambulation does not have an impact on the disease.

However, a child might experience fatigue with glomerulonephritis and can voluntarily restrict activities when the disease is most active. A child who has nephrotic syndrome might require albumin to correct hypoalbuminemia and extreme edema. Administering albumin causes serum albumin levels to rise and fluid shifts from the subcutaneous spaces into the bloodstream, which decreases edema. A child who has glomerulonephritis has mild edema, so albumin is not needed.

A child who has glomerulonephritis should have limited sodium intake, but there is no restriction on carbohydrate consumption. A nurse is assessing the pain level of a 3-year-old child who is postoperative following abdominal surgery.Sickle cell anemia or sickle cell disease a genetic blood disorder, which passed down through families, characterized by red blood cells that assume an abnormal, rigid, sickle shape.

Red blood cells contain an iron-rich protein called hemoglobin. This protein carries oxygen from the lungs to the rest of the body. In sickle cell anemia, hemoglobin, in the presence of low oxygen tension caused by hypoxia, acidosis, dehydration or feverit's crystallizes quickly, causing RBCs to bend in to crescent or sickle shape.

The sickle cells accumulate then obstructing capillary flow throughout the body. The thickened blood results in capillary stasis, obstructed blood flow and thrombosis. Ischemia occurs distal to thrombosis, causing further oxygen depletion and sickling, which can lead necrosis. The body hemolyzes the fragile sickle cells, quickly producing severe anemia. Possible causes of sickle cell anemia is genetic inheritance, that the child inherits the gene that produces hemoglobin S from two healthy parents who carry the defective gene.

Before age 4 months, symptoms are rare because fetal hemoglobin prevents excessive sickling. Infants: Splenomegaly from sequestered RBCs, Colic from pain caused by an abdominal infarction and Dactylitis or hand-foot syndrome from infarction of the small bones of the hands and feet.

Toddlers and preschoolers: Hypovolemia and shock from sequestration of large amounts of blood in spleen and Pain at site of vaso-occlusive crisis.

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School age children and adolescents: Enuresis, Extreme pain at crisis site, Poor healing of leg wounds from inadequate peripheral circulation of oxygenated blood, Delayed growth and development and delayed sexual maturity, History of pneumococcal pneumonia and other infection due to atrophied spleen and Priapism. RBCs are crescent-shaped and prone to agglutination.

Nursing Diagnosis for sickle cell anemia: 1. Acute pain. Ineffective tissue perfusion peripheral. Risk for infection. Deficient knowledge. Ineffective individual coping.

Compromised family coping. Treatment for sickle cell anemia: Bed rest. Hydration with I.Your child has sickle cell anemia. That means the red blood cells are abnormally C-shaped like a sickle instead of round. This can cause the sickle blood cells to get trapped in blood vessels.

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It can affect the blood's ability to carry oxygen. Sickle cell anemia runs in families, and often affects African Americans. It can be controlled with treatments. But the only cure is a bone marrow transplant. Your child was born with this condition. A sickle cell crisis happens when many sickled cells stick together and pile up in the blood vessels. During a sickle cell crisis, your child can have severe pain in the chest, stomach, arms, and legs. The crisis can last for hours, or even days.

It can happen several times a year. Over time, organ damage can also occur. Here's what you can do to help your child. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. Mount Nittany wants to provide the most relevant information to our community. Knowing where people live will help ensure that our content is valuable.

Learn more. Search Physicians Find Featured. What to watch for Be on the alert for: Any possible signs of infection, such as fever or shortness of breath Swollen, painful, red, or hot hands and feet Swollen belly Signs of fluid loss dehydration Sores ulcers on your child's legs. These are caused by poor blood flow. They are a sign that your child's sickle cell anemia is not under control.

Yellowing of the eyes or skin jaundice In boys, an erection that doesn't go away Pain that does not go away with treatment Abnormal speech, weakness in arms or legs, or uneven face that may mean a stroke Treatment What you can do: Get treatment right away if your child has a fever of This includes flu, colds, and skin infections.

Call your child's healthcare provider if you are unsure about how to treat your child. It is very important your child get correct treatment of health problems. This can prevent complications of sickle cell anemia. During a sickle cell crisis, keep giving your child pain medicine as prescribed by your child's provider. If the pain continues, call your child's provider.

Home care Do's and don'ts once your child is home: Encourage your child to get plenty of activity, but not to the point of becoming overly tired. Be sure your child drinks plenty of fluids during activity. Discuss with your child's provider which sports and what type of exercise are appropriate. Encourage your child to drink plenty of liquids, especially during warm weather.

This helps to prevent dehydration.Sickle-Cell Anemia Sickle-cell anemia is a term that denotes a group of genetic disorders caused by sickle shaped hemoglobin. In patients with this disease the human red blood cells take a different shape upon deoxygenation because of polymerization of the abnormal sickle hemoglobin. This process causes damage to the red blood cell membrane and causes the red blood cells to get attached in blood vessels.

This attachment or adherence of the red blood cells deprives the tissues of oxygen causing ischemia and infarction. The disease is chronic with periodic painful attacks, damage of internal organs with complications of strokes and subsequent shortened lifespan. Sickle-cell anemia is a specific form of sickle-cell disease caused by a homozygous mutation forming Hgb S.

Other forms of sickle-cell disease include sickle-haemoglobin C disease, sickle beta-plus-thalassemia, sickle beta-zero-thalassemia and hemoglobin ss caused by heterozygous genes Orah, Erythromycin prophylaxis may be used as an alternative for suspected penicillin allergy.

Routine medical evaluations includes review of previous disease symptoms, laboratory findings, monitoring growth and development, detection of early signs of organ damage Pass et. Nursing interventions for such painful episodes include obtaining history of past and present management, pain assessment self-report, assessment of physiologic indicators especially blood pressure, behavioral indicators like activity level, ease of movement of affected area, frequency, administration of pharmacologic interventions like use of anti-inflammatory, use nonpharmacologic interventions like heat, massage or guided imagery, hydration and prevention of complications.

The most common complication of an acute painful episode is acute chest syndrome that can be defined as any new infiltrate found on a chest x-ray Lane, Nursing interventions in acute chest syndrome include adequate pain control, promoting patient mobility and incentive spirometry Jakubik, Septicemia due to Streptococcus pneumoniae is a common cause of death in SCD children especially younger than 5 years old Reid et al.

This enhanced risk for such bacterial infections is attributed to splenic dysfunction. Nursing interventions includes prompt IV antibiotic and antipyretic administration, monitoring of vital signs for signs and symptoms of sepsis.

Splenic sequestration is a problem unique to children with SCD and is a significant cause of morbidity and mortality Kinney et. Nursing interventions for splenic sequestration include intravenous fluid administration, PRBC administration, and monitoring of cardiovascular status.

Splenectomy should be done if a child has two or more sequestration episodes on account of the mortality associated with severe splenic sequestration. But unfortunately, children with sickle cell disease undergoing splenectomy develop acute chest syndrome easily because of their inability to defend infections and postoperative complications of general anesthesia.

Nursing interventions include administration of broad spectrum antibiotics and vaccination against pneumococcus infection to prevent ACS Wong et al, A laparoscopic, intracorporeal, splenic fragmentation technique is being employed to remove spleens in SCD children to avoid such complications Phippen,This material must not be used for commercial purposes, or in any hospital or medical facility.

IU nurse invents medical device for people with sickle cell disease

Failure to comply may result in legal action. Medically reviewed by Drugs. Last updated on Feb 3, The sickle shape is caused by abnormal hemoglobin attached to the RBC. Hemoglobin carries oxygen to all tissues in your body. Sickle-shaped RBCs can get stuck to the walls of blood vessels. This can stop or slow blood flow, and prevent oxygen from getting to tissues.

When this happens, it is called a sickle cell crisis. A sickle cell crisis may be caused by illness, changes in temperature, stress, dehydration, or being at high altitudes. Do the following to help prevent a sickle cell crisis:.

Wear medical alert jewelry or carry a card that says you have sickle cell anemia. Ask your healthcare provider where to get these items. You may need ongoing screening for conditions that can develop because of sickle cell disease. Examples include kidney disease, hypertension high blood pressureretinopathy eye problemsand problems with your lungs. Write down your questions so you remember to ask them during your visits. The above information is an educational aid only.

It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records.

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Skip to Content. Sickle Cell Disease Medically reviewed by Drugs. More Information Medication Guide 1 related article Loading Care Notes 1 related article Loading Harvard Health Guide 1 related article Loading Mayo Clinic 1 related article Loading Related News and Articles. Subscribe to our newsletters. FDA Safety Alerts. Daily MedNews. Weekly Drug News Roundup.Which of the following aPTT values should the nurse expect?

Sickle Cell Disease

Which of the following actions by the nurse manager demonstrates a democratic leadership style? Which of the following actions should the nurse take?

The nurse should initiate a request for a high-frequency chest compression vest in response to which of the following parent statements? Which of the following instructions should the nurse give to the child?

a nurse is creating a plan of care for a child who has sickle cell

The client shows the nurse multiple superficial self-inflicted lacerations on her forearms. The nurse should identify these behaviors as characteristics of which of the following personality disorders? For which of the following findings should the nurse initiate a referral for occupational therapy?

Which of the following procedures should the nurse follow to ensure proper client identification? Which of the following actions should the nurse include in the plan? There are three tabs that contain separate categories of data. Which of the following findings should the nurse expect?

Which of the following statements should the nurse make? Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero. Which of the following laboratory results indicates that the treatment regimen is effective? Which of the following statements should the nurse include in the teaching? Which of the following observations should the nurse identify as an indication for potential violence? Which of the following nutrients should the nurse instruct the client to decrease in his diet?

Which of the following client actions indicates an understanding of the teaching? Which of the following findings should the nurse identify as an indication that the medication is effective?

Which of the following components of the MSE is the priority for the nurse to assess? The nurse should plan to perform which of the following actions? Which of the following tasks should the nurse delegate to an assistive personnel AP?

The nurse should identify which of the following findings as a potential indication of sexual abuse? Which of the following interventions should the nurse use to maintain surgical aseptic technique? Which of the following children should the nurse assess first? The nurse manager should tell the nurses that informed consent promotes which of the following ethical principles?

The nurse should expect the provider to order which of the following diagnostic tests? For which of the following clients should the nurse intervene to prevent a potential food and medication interaction?

a nurse is creating a plan of care for a child who has sickle cell

Which of the following tasks should the nurse assign to the member of the group functioning as the orienter? Which of the following interventions should the nurse implement first? Which of the following interventions by the nurse requires completion of an incident report?Nursing Care of Children 2 Marvel Brown. Which of the following statements by the parent indicates an understanding of the teaching? Which of the following finding should the nurse expect?

Which of the following responses by the adolescent indicates an understanding of the teaching? Which of the following instructions should the nurse include?

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Which of the following statements should the nurse include in the teaching? Which of the following actions should the nurse take first? Which of the following instructions should the nurse include in the teaching? Which of the following breakfast foods should the nurse recommend? Which of the following findings should the nurse report to the provider? Which of the following interventions should the nurse include in the plan? Which of the following dietary recommendations should the nurse make?

Which of the following findings should the nurse include in the teaching? Which of the following values for urine specific gravity should the nurse expect? Which of the following instructions should the nurse include in the plan? Which of the following responses by the parents indicates an understanding of the teaching? The nurse should teach the newly hired nurse to monitor the infant for which of the following complications? Which of the following responses should the nurse make?

Sickle Cell Crisis

Which of the following actions should the nurse take? Which of the following findings should alert the nurse to the possibility of epiglottitis? Which of the following findings should the nurse expect? Which of the following findings is the priority for the nurse to report to the provider?

The parents of the child ask the nurse how the diagnosis is made. Which of the following forms of feeding should the the nurse anticipate for the infant 6 hr after the procedure? Which of the following findings indicates the infant has moderate dehydration? Which of the following laboratory values should the nurse report to the provider?

The nurse should plan to feed the infant using which of the following instruments?

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