Posted: January 28th, 2024

Brittany Long is a 5-year-old African American female

Patient Introduction
Brittany Long is a 5-year-old African American female with a history of sickle cell disease, diagnosed at 6 months old, and has been prescribed regular folic acid supplement.
She was brought into the emergency department during the night by her mother, who stated that the patient has been complaining of right lower leg pain over the last 2 days. Brittany rated her pain as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids.
She has had pain crises before, mostly managed at home with acetaminophen and ibuprofen. She has been hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years for a fever.
Brittany was given oral pain medication in the emergency department at 6:00 AM. She is asleep but is responsive when awakened. She has been taking small amounts of oral fluids and continues to receive intravenous maintenance fluids at 52 mL/hr. When examined this morning, her blood pressure was 101/70 and her temperature was 37.4°C (99°F). She now rates her pain as a 3. New orders have been given.
Medication: Morphine

Brittany is presenting with symptoms consistent with a vaso-occlusive crisis related to her sickle cell disease, including pain localized to her lower right leg that began 2 days ago and has progressively worsened (Ballas et al., 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap). Her report of pain rated at 5/10 on the FACES scale upon initial presentation to the ED is concerning and suggests she is experiencing moderate to severe pain (Hicks et al., 2001).
The emergency department’s initial treatment of oral pain medication and intravenous fluids was appropriate. Morphine has been shown to effectively manage acute sickle cell pain when administered intravenously or orally (Brousseau et al., 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer). Continued intravenous hydration is also important to prevent worsening of symptoms (Yawn et al., 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Brittany reporting a decreased pain level to 3/10 after initial treatment suggests the interventions provided relief and were well-tolerated.
Some additional factors to monitor in Brittany’s case include potential causes of her decreased appetite and making sure she continues adequate oral intake. Loss of appetite can occur in sickle cell pain crises and increase risk of complications like infection if nutrition and hydration status decline (Ballas, 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap). Close monitoring of her vital signs is also warranted, given her history of prior hospitalizations, to promptly identify any developing complications like infection.
Continued reassessment of Brittany’s response to the pain medication regimen will also help guide further treatment decisions. If her pain increases again or she shows signs of inadequate pain control, it may be necessary to adjust the medication dose or route of administration (Brousseau et al., 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer). Overall, Brittany seems to be receiving appropriate initial management of her sickle cell pain crisis based on current evidence-based guidelines.

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