Question

A child with sickle cell disease is brought to the hospital reporting right knee pain. On examination, the nurse finds localized swelling and immediately applies a cold compress to the right knee, massages the knee, and administers ibuprofen for pain relief. The nurse informs the mother that the child may need a high dose of an opioid if there is no relief from pain. Which of the measures taken by the nurse need to be corrected?

a) Applying a cold compress.
b) Massaging the knee.
c) Administering ibuprofen.
d) Informing about opioid use.

Answer 1

The nurse's action that requires correction in treating a child with sickle cell disease is the massaging of the knee, which could worsen the condition by dislodging clots or exacerbating vaso-occlusion.

Step-by-step explanation:

A child with sickle cell disease is brought to the hospital reporting right knee pain. When assessing the measures taken by the nurse, it is the massaging of the knee that needs correction. People with sickle cell disease can experience acute pain episodes or sickle cell crises, which are often precipitated by factors that can increase the risk of sickle cells blocking blood flow and causing infarcts and tissue damage. Massage could potentially dislodge clots or exacerbate vaso-occlusion, leading to worsening of symptoms. While NSAIDs like ibuprofen can help reduce inflammation and relieve pain, they should be taken with caution due to their blood-thinning properties. The nurse's consideration of opioids for pain relief is appropriate if the pain does not respond to initial treatments, but close monitoring for potential addiction and other serious side effects is essential.