Brittany Long Discussion Questions

1.Whati st her el at i ons hi pbet weenfl ui dandox y gent her apyi nt het r eat mentofsi ckl e cel l anemi a?Li qui dt her apyi st odi l ut et hebl oodandoxy gent her apyi st ocount er actt he di sr upt i onofoxy gent ot i s s ues . 2.Whatc ompl i cat i onsmi ghtBr i t t anyLongf acei fhers y mpt omsar enotr ecogni z edand t r eat edi nat i mel ymanner ?Poss i bl ecompl i cat i onst os i ckl ecel l i ncl udest r ok e,chest s y ndr ome,pul monar yhy per t ens i on,or gandamage,t i s s uedamage,bl i ndnes s,l eg ul cer s ,gal l s t ones ,v as ooc c l us i v ecr i s i s ,s eques t r at i on,apl ast i ccr i si s,hyperhemol yt i c cr i si s . 3.Whatmet hodsofpai nmanagementdi dy ouuseandwhatot hermet hodsshoul dbe consi der edf orBr i t t anyLong,bas edont hel at es tev i dencebasedpr act i ce?I nt he scenar i ot hepat i entwasr ecei vi ngcodei ne,ac et ami nophen,i bupr of enandmor phi net o t r eatpai nphar maceut i c al .Sheal s or ec ei v edfl ui dst odi l ut et hebl oodandox y gent o r educei s chemi cpai n.Ot hermet hodst hatcoul dhav ebeenusedi ncl udeheat i ngpads t oaffect edar ea,mas sage ,ac upunc t ur e,r el ax at i ont echni quesanddi st r act i onsf r om t he pai n. 4.Whatdi s c har get eac hi ngs houl dbepr ovi dedt oas s i s tBr i t t anyLong’ smot herwi t hher homec ar e ?Pr ovi deemot i onal s uppor t ,obs er v ef ormani f est at i onsofcr i si sand i nf ect i on,andi nf or m pr ov i derASAP,pr omot er es tandadequat enut r i t i on,pr act i cegood hy gi eneandav oi ds i c ki ndi v i dual s,adher et ohy dr at i onr equi r ement st opr ev ent dehy dr at i on,mai nt ai nupt odat ei mmuni z at i ons ,wearamedi calal er tbr acel et ,at t end school r egul ar l ybutav oi dcont ac ts por t s . 5.Reflec tonway st oi mpr ov es af et yandqual i t yofc ar ebasedony ourexper i enc ewi t h Br i t t anyLong’ scase.I ti si mpor t antt omanaget hepat i ent spai nasi tcausedel ev at i on ofherr espi r at i onr at e,hear tr at eandbl oodpr es sur e.Fur t heri ti si mpor t antt omoni t or f orwor seni ngs y mpt omsofpai n,di ffic ul t ybr eat hi ng,ot hersi ght sofpai nand neur ol ogi cal changesi nt hepat i ent . 6.I dent i f yaddi t i onal i ndi vi dual swhos houl dbei nc l udedonBr i t t anyLong’ scar et eam.I n addi t i ont ot hepr ovi deratt hehospi t ali twoul dbegoodt ohaveahemat ol ogi st , ani nt er ni st ,aneur ol ogi st ,nephr ol ogi standadi et i t i anonboar dt ohel ppl anher di et ar yandhydr at i onr equi r ement s,moni t orherscansi ncaseofst r okeandt o haveoncal li ncaseofi nvol vementofot hersyst ems. 7.Whatkeyel ement swoul dy oui nc l udei nt hehandoffr epor tf ort hi spat i ent ?Consi der t hes i t uat i onbac k gr oundass es s ment r ecommendat i on( SBAR)f or mat . BLi sa5y ear ol df emal ewi t haHxofs i ckl ecel lanemi a.Shehashad2pas tepi sodes ,1at3y ear sof ageand1at4y ear sofage.Shepr es ent edwi t ha3ont hef acesscal eandpai nwi t h war mt ht ot het ouc hofherl owerr i ghtl eg.Herv i t al swer eRR24,HR134,SpO2of99% on2Lnas alcanul a,BPof112/ 75andt emper at ur eof99* F.Herl absshowal ow cr eat i ni neat0. 4,l owHbof9. 8,l owHctof29andel ev at edr et i cul ocyt esof5. 5.The pr ov i deror der edabol usof250mL0. 9% NSand2mgI Vmor phi nesul phat e.Af t er admi ni s t r at i onherpai nonFac eswas1,RR16,HR104andBPof94/ 64.Pat i enti s r es t i ngqui et l ynowy eteas i l yr ous abl e.Hermot heri sc ur r ent l yatbedsi de. 8.Di s cussqual i t y of car ei ndi cat or sf ort hemanagementofchi l dr enwi t hsi c kl ecel l di seas e.Ti mel yc ar eandasses smentofpai nandf ev er ,c ompr ehens i v epl anni ng, pr ophyl ac t i cant i bi ot i csandt r ans f us i onsofbl ood.