I'm a 3rd year nursing student and I'm doing my internship in a Ped. day center. Some of the patients are diagnosed with sickle cell anemia. I wanted to know what are the nursing interventions that are done at your workplace with these patients. How is the pain assessed in children with this decease at your unit.
Mar 10, '12
Ashley, some of our hematologists recommend very conservative fluid replacement in sickle cell crisis because of potential issues with acute chest. I guess their belief is that overloading with fluids can increase the likelihood of developing acute chest? Is that something you've seen in your practice? I have frequently had patients where there are orders for maintenance fluids and pain meds but no bolus or a 10ml/kg instead of a 20ml/kg.
To the OP, I've had patients who have developed varying degrees of allergy to morphine, so frequently we will administer benadryl prior to giving morphine and when we do not, be on the lookout for reactions (I had a patient develop hives in a line along the vein within minutes of administering their morphine- they'd never had issues with it before and now will need benadryl). We also use warm packs to painful areas or a gaymar pump. We assess pain in the same way we do with other patients (FLACC, OUCHER, or number scale).
Last edit by hiddencatRN on Mar 10, '12