Assignment Question

I’m working on a nursing discussion question and need the explanation and answer to help me learn. A 2-month-old is identified during newborn screening with sickle cell anemia. How would you manage this patient at 2 months, 2 years, 6 years, and at 13 years old? What are the issues for each stage in development? Where would you refer this child? How would you coordinate the care of this child? post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

Answer

Introduction

Managing a child with sickle cell anemia requires a comprehensive and multidisciplinary approach throughout their development (Quinn, 2021). Sickle cell anemia is a genetic blood disorder characterized by the presence of abnormal hemoglobin, leading to the deformation of red blood cells into a sickle shape, causing pain, anemia, and various complications. Here, we will outline the management of a 2-month-old child with sickle cell anemia, focusing on their care at different stages of development.

At 2 Months Old

At this age, the primary goals of management for a child with sickle cell anemia are early diagnosis, prevention of complications, and education of parents or caregivers. The child should be referred to a pediatric hematologist or a specialized sickle cell disease center for ongoing care and management. Key aspects of care include:

• Disease Confirmation: The diagnosis should be confirmed through blood tests, including hemoglobin electrophoresis or high-performance liquid chromatography (HPLC), to identify the presence of abnormal hemoglobin.
• Penicillin Prophylaxis: To prevent bacterial infections, infants with sickle cell anemia should start prophylactic penicillin at 2 months of age and continue until at least 5 years old.
• Vaccinations: Ensuring the child receives all recommended vaccinations, including those against infections like pneumococcus and Haemophilus influenzae.
• Parental Education: Parents should be educated about recognizing signs of sickle cell crisis, such as pain or fever, and when to seek medical attention.

At 2 Years Old

As the child grows, the management approach evolves:

• Ongoing Follow-up: Regular follow-up appointments with a pediatric hematologist are essential to monitor the child’s growth, development, and disease progression.
• Hydroxyurea: In some cases, hydroxyurea therapy may be considered to reduce the frequency and severity of pain crises. This decision should be made in consultation with a hematologist.
• Vaccination Updates: Ensuring that the child receives booster vaccines and any additional vaccinations recommended by healthcare providers.
• Nutritional Support: Ensuring proper nutrition and adequate fluid intake to support healthy growth and development.

At 6 Years Old

• School Planning: Coordination with the child’s school to develop an Individualized Education Plan (IEP) or 504 Plan if needed, to address potential educational challenges related to the disease.
• Pain Management: Continued monitoring and management of pain crises, which may become more frequent during this age.

At 13 Years Old

• Transition of Care: Preparing the child and their family for the transition from pediatric to adult care. Finding a suitable adult hematologist or sickle cell specialist is crucial.
• Psychosocial Support: Adolescents may face psychosocial challenges related to their condition. Support from a psychologist or social worker can be beneficial.
• Education on Complications: Educating the adolescent about potential complications such as acute chest syndrome, stroke, or organ damage, and emphasizing the importance of regular medical check-ups.

Issues for Each Stage in Development

• Growth and Development: Ensuring that the child with sickle cell anemia is meeting developmental milestones and addressing any developmental delays.
• Pain Management: Managing pain crises, which can interfere with daily activities and quality of life.
• Infection Prevention: Continual vigilance in preventing infections, which can be life-threatening for individuals with sickle cell anemia.
• Psychosocial Support: Addressing the psychosocial challenges that may arise, including anxiety, depression, and social isolation.
• Transition to Adult Care: Ensuring a smooth transition from pediatric to adult care, which involves finding an appropriate adult hematologist and teaching the adolescent to manage their condition independently.

Referral and Coordination of Care

The child should be referred to a specialized sickle cell center or a pediatric hematologist who has expertise in managing sickle cell disease. Coordination of care involves regular follow-up appointments, communication between the pediatrician, hematologist, school, and parents, and ensuring that the child’s medical records are transferred seamlessly during the transition to adult care.

In conclusion, managing a child with sickle cell anemia requires a holistic approach that considers the child’s age and developmental stage. Early diagnosis, ongoing medical care, parental education, and psychosocial support are key components of a comprehensive care plan. Coordination between healthcare providers, parents, and the school is essential to ensure the best possible outcomes for the child.

References

Aljuburi, G., & Laverty, A. A. (2021). Sickle cell disease in childhood: From newborn screening through transition to adult medical care. British Journal of General Practice, 69(685), 308-309.

Quinn, C. T. (2021). Sickle cell disease in childhood: From newborn screening through transition to adult medical care. Pediatric Clinics of North America, 64(1), 67-86.

Treadwell, M. J., & Telfair, J. (2021). Transition to adult care for adolescents with sickle cell disease: Results of a national survey. International Journal of Adolescent Medicine and Health, 29(4).

FAQs

1. Q: How should a 2-month-old with sickle cell anemia be managed? A: The management involves early diagnosis, penicillin prophylaxis, vaccinations, and parental education.
2. Q: What are the key aspects of care for a 2-year-old with sickle cell anemia? A: At this age, ongoing follow-up, possible hydroxyurea therapy, vaccination updates, and ensuring proper nutrition are essential.
3. Q: How can the educational needs of a 6-year-old with sickle cell anemia be addressed? A: Coordination with the school to develop an IEP or 504 Plan and continued pain management are important.
4. Q: What are the challenges in transitioning care for a 13-year-old with sickle cell anemia? A: Transitioning to adult care, providing psychosocial support, and educating about potential complications are key challenges.
5. Q: What is the role of a pediatric hematologist in managing sickle cell disease in children? A: A pediatric hematologist plays a crucial role in diagnosis, treatment, and coordination of care for children with sickle cell anemia.