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
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Repeated vaso-occlusive crises results in tissue damage caused by oxygen deprivation. Pain results from ischemia and gradual deterioration in tissue and organ function (Paterson, 2012). The acute chest syndrome is a vaso-occlusive crisis within the lungs with evidence of a new infiltrate on chest x-ray. The patient is two years old and may not be able to localize pain. His symptoms may include cough, increasing respiratory rate, heart rate, hypoxia, and progressive respiratory distress (Marcdante & Kliegman, 2015). Early awareness of an acute chest syndrome is focused on the prevention of arterial hypoxemia. It would be essential to obtain baseline chest x-ray. This patient will need oxygen therapy, fluids to prevent dehydration, bronchodilators, antibiotics and possibility a RBC transfusion (Marcdante & Kliegman, 2015). The use of an incentive spirometer may help reduce the frequency of acute chest crisis. The patient may also experience a pain crisis. Pain may include long bones of the arms or legs but may occur in smaller bones. Painful episodes may last from 2 to 7 days. Treatment of pain includes fluid administration, analgesia, and …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,
Repeated vaso-occlusive crises results in tissue damage caused by oxygen deprivation. Pain results from ischemia and gradual deterioration in tissue and organ function (Paterson, 2012). The acute chest syndrome is a vaso-occlusive crisis within the lungs with evidence of a new infiltrate on chest x-ray. The patient is two years old and may not be able to localize pain. His symptoms may include cough, increasing respiratory rate, heart rate, hypoxia, and progressive respiratory distress (Marcdante & Kliegman, 2015). Early awareness of an acute chest syndrome is focused on the prevention of arterial hypoxemia. It would be essential to obtain baseline chest x-ray. This patient will need oxygen therapy, fluids to prevent dehydration, bronchodilators, antibiotics and possibility a RBC transfusion (Marcdante & Kliegman, 2015). The use of an incentive spirometer may help reduce the frequency of acute chest crisis. The patient may also experience a pain crisis. Pain may include long bones of the arms or legs but may occur in smaller bones. Painful episodes may last from 2 to 7 days. Treatment of pain includes fluid administration, analgesia, and …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,