Posted: June 12th, 2023

Roslyn, a six-year-old, is attending public school for the first time

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?

The priority nursing interventions for Roslyn include:

Managing pain. Sickle cell anemia can cause severe pain, which can be difficult to manage. The nurse will work with Roslyn and her parents to find a pain management plan that works for her. This may include medication, heat therapy, and relaxation techniques.
Preventing infection. Sickle cell anemia patients are more susceptible to infection. The nurse will teach Roslyn and her parents how to prevent infection, such as washing their hands frequently and getting vaccinated.
Promoting coping skills. Sickle cell anemia can be a difficult condition to live with. The nurse will help Roslyn and her family develop coping skills to deal with the challenges of the disease. This may include stress management techniques, relaxation exercises, and support groups.

The nurse should provide Roslyn and her family with the following anticipatory guidance regarding the diagnosis of sickle cell anemia and her attending school:

Sickle cell anemia is a chronic disease that causes red blood cells to become sickle-shaped. These sickle-shaped cells can block blood flow, which can cause pain, swelling, and other problems.
Sickle cell anemia is not contagious.
Roslyn can still attend school and participate in most activities. However, she may need to take breaks during the day to rest and drink fluids.
Roslyn should tell her teachers and classmates about her condition. This will help them understand why she may need to miss school or take breaks during the day.
Roslyn should carry a medical alert bracelet or necklace at all times. This will let people know that she has sickle cell anemia and what to do if she has an emergency.

The nurse can support Roslyn and her family by:

Providing emotional support. Sickle cell anemia can be a difficult condition to live with. The nurse can provide emotional support to Roslyn and her family to help them cope with the challenges of the disease.
Offering resources. There are many resources available to help people with sickle cell anemia. The nurse can offer these resources to Roslyn and her family to help them learn more about the disease and how to manage it.
Advocating for Roslyn. The nurse can advocate for Roslyn to make sure that she gets the care she needs. This may include working with her school to make sure that she has the accommodations she needs to succeed.

The nurse should provide Roslyn and her parents with the following discharge instructions:

Take Roslyn’s temperature every day. If her temperature is over 100 degrees Fahrenheit, contact her doctor.
Monitor Roslyn for signs of infection, such as fever, chills, cough, or sore throat. If you see any of these signs, contact her doctor.
Make sure Roslyn gets plenty of fluids.
Encourage Roslyn to eat a healthy diet.
Get Roslyn vaccinated against pneumonia and influenza.
Teach Roslyn how to manage her pain.
Teach Roslyn how to prevent infection.
Contact Roslyn’s doctor if she has any questions or concerns.

Roslyn may have some activity restrictions after discharge. These restrictions will vary depending on her individual condition. However, she may need to avoid strenuous activity, such as sports or running. She may also need to take breaks during the day to rest and drink fluids

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