December 2002, Volume 32 Number 12 , p 32hn1 - 32hn7
Assessing your patient
Combating multiple problems
Carrying out the care plan
Getting ready for discharge
Beware of these complications
Medications to manage the pain
SELECTED WEB SITES
Learn the complex problems this disease triggers and how to support your patient during a crisis.
Sterling Jackson, 21, who has a history of sickle-cell anemia, is admitted to the medical/surgical unit from the emergency department (ED). He developed severe pain in his chest, arms, legs, and back about 10 hours ago. After 4 hours receiving intravenous (I.V.) nalbuphine (Nubain), ketorolac (Toradol), and hydration in the ED, he still rates his pain as 6 on a visual analogue scale, and his blood work shows worsening anemia from his baseline level.
The most common genetic disorder in the United States, sickle-cell disease affects about 70,000 people. Although most common in African-Americans, it also affects people whose ancestors came from parts of the world where malaria is endemic. Having one sickle-cell gene (known as sickle-cell trait) provides some protection against malaria, but having two causes sickle-cell disease.
Years ago, people with sickle-cell disease died in their teens. Today, with improved education and treatment, some live into their 60s, but they're susceptible to sickle-cell crises all their lives. In this article, we'll explain what's causing Mr. Jackson's problems and how you can help him through the crisis.
Faulty hemoglobin ...