What are the priority nursing interventions for Roslyn?

Case Study: Roslyn, a six-year-old, is attending public school for the first time. Her parents brought her to the clinic and stated, “she appears to have pain in her legs and won’t participate in playtime.” The parents noticed recently Roslyn appears pale and acts weak. Roslyn is diagnosed with sickle cell anemia. After her parents and siblings undergo genetic testing, it is found that Roslyn is the only family member with the disease.
What are the priority nursing interventions for Roslyn?
What anticipatory guidance should the nurse provide Roslyn and her family regarding the diagnosis of sickle cell anemia and her attending school?
How can the nurse support the child and family?
What discharge instructions should the nurse provide to Roslyn and her parents?
What, if any, activity restrictions will Roslyn have after discharge?

ANSWER
Priority Nursing Interventions

Pain Management: Sickle cell anemia is characterized by recurrent episodes of pain, known as sickle cell crises. These crises are caused by the sickle-shaped red blood cells clogging small blood vessels, leading to tissue hypoxia and pain. The nurse should assess Roslyn’s pain level regularly and administer pain medication as prescribed.

Hydration: Adequate hydration is crucial for preventing sickle cell crises. Encourage Roslyn to drink plenty of fluids throughout the day, including water, juice, and electrolyte drinks.

Folic Acid Supplementation: Folic acid plays a vital role in red blood cell production. Supplementation with folic acid can help prevent anemia and reduce the frequency of sickle cell crises.

Infection Prevention: Sickle cell patients are more susceptible to infections due to weakened immune systems. The nurse should educate Roslyn and her family about infection prevention measures, such as handwashing, avoiding close contact with sick individuals, and maintaining good hygiene.

Stress Management: Stress can trigger sickle cell crises. The nurse should teach Roslyn and her family stress management techniques, such as relaxation exercises and deep breathing.

Anticipatory Guidance

Explanation of Sickle Cell Anemia: The nurse should explain the condition of sickle cell anemia to Roslyn and her family in a child-friendly manner, using age-appropriate language.

Symptoms and Management: Educate Roslyn and her family about the symptoms of sickle cell crises and how to manage them, including pain management, hydration, and seeking medical attention promptly.

School Attendance: Discuss strategies for Roslyn to maintain regular school attendance, such as avoiding strenuous activities, staying hydrated during school hours, and communicating with teachers about her condition.

Emergency Plan: Develop an emergency plan with Roslyn and her family, including when to seek medical attention, who to contact in case of a crisis, and what medications to have on hand.

Supporting the Child and Family

Emotional Support: Provide emotional support to Roslyn and her family as they adjust to the diagnosis of sickle cell anemia. Acknowledge their emotions and offer reassurance and guidance.

Community Resources: Connect Roslyn and her family to local support groups and resources for sickle cell patients and their families.

Advocacy: Advocate for Roslyn’s needs at school and in the community, ensuring she receives appropriate accommodations and support.

Discharge Instructions

Medication Regimen: Provide clear instructions on Roslyn’s medication regimen, including dosage, frequency, and potential side effects.

Pain Management Strategies: Educate Roslyn and her family on pain management strategies, including over-the-counter pain relievers, non-pharmacological techniques, and when to seek medical attention.

Hydration and Nutrition: Emphasize the importance of adequate hydration and a healthy diet to maintain overall health and prevent sickle cell crises.

Infection Prevention: Reinforce infection prevention measures, such as handwashing, avoiding contact with sick individuals, and maintaining good hygiene.

Activity Restrictions: Discuss any activity restrictions, particularly during periods of pain or illness, to prevent complications.

Follow-up Appointments: Schedule regular follow-up appointments with a hematologist to monitor Roslyn’s condition and provide ongoing care.

Activity Restrictions

Roslyn may need to limit certain activities that could trigger sickle cell crises, such as strenuous exercise, exposure to extreme temperatures, and high altitudes. It is important to work with her healthcare provider to develop a personalized activity plan that balances her physical activity needs with managing her condition.