an African American young adult is admitted to ER in sickle cell crisis with 10/

Question

an African American young adult is admitted to ER in sickle cell crisis with 10/10 pain. patient is known to several nurses and physicians in the department who have labeled him as a "drug seeker".

identify 1 intervention that can be taken by the RN to reduce the stigma and improve the management of acute chronic pain associated with sickle cell disease.

does the intervention apply only to the interprofessional team? does it apply to both patient and members of the interprofessional team? explain and support answer

Explanation / Answer

Sickle cell pain episode is caused by ischemic tissue due to the prevention of flow of blood by sickled red blood cells. If the blood flow stops it leads to hypoxia and acidosis that enhances the sickling process. Sickle cells interact with the vascular endothelium that contributes to the manifestation of sickle cell disease. Pain episodes are precipitated by certain factors such as infection, hypoxia, dehydration, menstruation, acidosis, sleep apnea, and exposure to cold temperatures.

According to the instructions given by Indiana Hemophilia & thrombosis center Inc., management of acute chronic sickle cell pain can be done with early treatment using analgesics, rest, warmth and oral hydration. Home based management includes the treatment regime like this.

For mild pain- oral hydration of 3 to 4 liters of water per day , acetaminophen 325 to 1000mg for every 4 hours, ibuprofen 400 to 800mg for every 6 to 8 hours along with massage therapy.

For moderate pain – codeine 30 to 60 mg every 4 hours and oxycodone 5 to 10 mg every 4 hours

For severe pain – oral morphine of 30 to 60mg for every 3 hours, oral hydromorphone or dilaudid of 4 to 8 mg for every 4 hours.

This medication is for the patient and not for the inter-professional team.

Reference: www (dot) ihtc (dot) org.

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