Sickle Cell Disorder Case Study

Sickle Cell Disorder [ICD-10 D57] Sickle Cell Disorder (SCD) may be one cause to this child’s previously listed symptoms. SCD is an inherited disease in which an abnormal hemoglobin S [HbS] leads to chronic hemolytic anemia, pain, and organ failure (Grossman & Porth, 2014). SCD is transmitted by a recessive gene and can manifest as a sickle cell trait or sickle cell disease. The sickle cell trait may manifest as a heterozygote with one HbS gene [HbS], and SCD may manifest as a homozygote with two HbS genes [HbSS] (Grossman & Porth, 2014). The atypical appearance of HbS results from a mutation within the hemoglobin molecule. Deoxygenated hemoglobin becomes sickled at low oxygenated tension, and the concentration of HbS correlates with the risk of blood cell sickling. The “deoxygenated hemoglobin aggregates and polymerizes in the cytoplasm, creating a semisolid gel that changes the shape and deforms the cell” (Grossman & Porth, 2014). The cell may return to its normal shape after oxygenation occurs in the lungs, but there is a risk of permanent sickling if repeated …show more content…
The unfortunate side effects of using opioids may include nausea, vomiting, pruritis, constipation and urinary retention. More serious side effects can present as challenges such as respiratory depression, oversedation, or delirium (ncbi.nlm.gov, 2010). Children may become tolerant to opioids due to repeated use. For more severe pain, the patient can be given Roxicodone 0.05-0.15mg/kg by mouth every 4 to 6 hours (epocrates.com, 2016). When using narcotics, using the shortest effective treatment necessary is optimal. Give this with food to prevent nausea. Common reactions to this medication are nausea, vomiting, headache, pruritis, and dysphoria. More severe reactions may include a hypersensitivity, respiratory depression, respiratory arrest, cardiac arrest, dependency, hypotension, and paralytic ileus (epocrates.com,