peps C4

Patient Introduction

Brittany Long is a 5-year-old African American female with a history of sickle cell anemia (HbSS) treated with regular folic acid supplement who came in yesterday with an acute vaso-occlusive pain crisis. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. Her spleen is palpated 3 cm below the left costal margin. She rated her abdominal pain a 5 on the FACES Scale and received morphine sulfate. She continues to receive intravenous maintenance fluids at 52 mL/hr and is on a nasal cannula with oxygen 2 L/min. She is pale and weak and just wants to sleep. Her mother is concerned about her increasing fatigue. Her urinary output is decreased, and she no longer wants to take fluids by mouth, not even for mom. Her vital signs have been taken every 2 hours, and she had labs drawn twice. Her last hemoglobin was decreased by 1.3 g/dL, and is now 7.5 g/dL; platelets are also decreasing and are 200; her reticulocyte count is increasing and is 7.5. Legal consent to give blood products has been obtained from the mother.

Pediatric Nursing Care

1. Kyle, T., and Carman, S. (2021). Essentials of Pediatric Nursing, 4th Edition.

2. Sickle Cell Disease, Chapter 24, pp. 869-874

3. Drug Guide 24.1, Chapter 24, pp. 856-859

4. Common Laboratory and Diagnostic Tests 24.1, Chapter 24, p. 848

5. Common Medical Treatments 24.1, Chapter 24, pp. 854-855

6. Nursing Process Overview for the Child in Pain, Chapter 14, pp. 390-398

7. Developmental Considerations (Preschoolers), Chapter 14, p. 389

8. Pharmacologic Management, Chapter 14, pp. 405-414

9. Rapid Cardiopulmonary Assessment, Chapter 29, pp. 1033-1034

10. Shock, Chapter 29, pp. 1052-1055

Diagnostic Tests

1. Expert Clinical Content from Lippincott Advisor

2. Red Blood Cell Count  Red Blood Cell Count

From vSim for Nursing | Pediatric. © Wolters Kluwer Health.

From vSim for Nursing | Pediatric. © Wolters Kluwer Health.