The parents of an 8-year-old child with sickle cell anemia call ...

[FButt]

The parents of an 8-year-old child with sickle cell anemia call the clinic to report that the child developed chest pain after playing soccer. What advice from the nurse is most appropriate?
 
  A.
  Go to the nearest emergency department.
  B.
  Have him rest and take Tylenol (acetaminophen).
  C.
  If he doesn't improve, bring him in to the clinic.
  D.
  Try a warm pack on his chest for 10 minutes.

Question 2

A teenager is hospitalized with sickle cell disease and vaso-occlusive crisis. What pain medication regimen does the nurse assist the patient with?
 
  A.
  Acetaminophen (children's Tylenol)
  B.
  Ketorolac (Toradol) orally
  C.
  Meperidine (Demerol), given intravenously
  D.
  PCA pump with morphine (Duramorph)

[whitcassie]

Answer to Question 1

ANS: A
In sickle cell disease, the abnormally shaped RBCs are sticky and adhere to the blood vessel walls, creating obstructions to circulation. This creates the potential for tissue ischemia and death. The child could be having a heart attack and needs immediate evaluation.

Answer to Question 2

ANS: D
A teenager is able to manage his or her own pain control, so a PCA pump is ideal. Morphine is often considered the drug of choice in sickle cell crises. Tylenol would be ineffective for pain this severe. Demerol is avoided due to its side effects. Toradol is a good choice; however, it is given parenterally for severe, acute pain.

[FButt]

Thank you

[whitcassie]

Happy to help you