Question

The disease is Sickle Cell Rubric Define your disease, (pathophysiology) in detail to the class, then-(20) 1. Identify health related issues associated with your disease process-(10) 2. Compare and contrast developmental task theory (Robert Havighurst), and the psychosocial theory (Erikson) of growth and development-(10) 3. Identify conditions that influence growth and development at all ages-(10) 4. Discuss cognitive and psychosocial challenges for peds patients with this disease-(10) 5. Describe special assessments unique for this age group-(10) 6. Discuss age-appropriate interventions for a specific age group-(10) 7. Incorporate developmental principles into nursing care-(10) All groups must hand in one typed report. Everyone will receive the same grade for the presentation. All references must be in APA format

Answer 1

1. Sickle cell disease is a disorder of hemoglobin in which hemoglobin changed to abnormal shape called as Hemoglobin S

2. Pathophysiology

                         Due to etiological factor that causes abnormal shape of hemoglobin production

When there is decreased oxygen supply that causes polymerization of hemoglobin,, leads to sickling shape of cell.

When there is an injury to endothelial cells that causes RBC, Leukocytes adhesion to the endothelium that causes vasoconstriction

This leads vascular occlusion leads to decreased blood supply to the organ, organ suffers from decreased blood supply and oxygen

3. Health related issues

· Patient presents with anemia because of decreased RBC life span. Normal RBC live for 120 days whereas Sickling RBC cell live for 20 days

· Patient experiences pain as a result of occlusion of tiny blood vessels by the sickling red cell in various parts of the body

· Patient is chanced to have infection because of spleenic damage as a result of sickling cells and chance to have infections

· Patient growth and development affected due to decreased oxygen and nutrition carrying capacity of red cells

· Swelling hands and feet; the patient is chanced to have swelling of feet and hands due to   blocking tiny blood vessels

· Vision problems: the patient experiences vision problems as a result of blocking of tiny blood vessels of the eye.

4. Compare and contrast psychosocial theory and developmental task theory

	Psychosocial theory	Havighurst developmental task
Task	Task appears at certain stage of life	It also appears at certain stage of life
Stages	It explains regarding stages of development in a life span	It also explains stages of life in a life span
Development	It explains regarding the development task at each stage	It also explains developmental tasks in each stage
Outcome	Success of the task in each stage, leads to health personality	Success of task brings satisfaction   to the person
Failure	If the task breakdown, it leads to negative and unhealthy personality	If the task fails, it leads to unhappiness and   bring difficulty task

Creator	Erikson	Robert havighurst
Year	It was introduced 1958	It was introduced in 1950
Stages	It has eight stage	It has seven stages of developmental task
age	It covers age differently Infant to 18 months 18 months to three year 3 -5 year 5-13 year 13 to 21 year 21 to 39 year 40-65 year 56 and older	It covers age differently 0-5 years old 6-12 year old 13-17 year old 18 -35 years old 36-60 years Over 6 years
Name of development	Trust vs mistrust Autonomy vs shame and doubt Initiative vs guilt Industry vs inferiority Identity vs role confusion Intimacy vs isolation Generosity vs stagnation Ego integrity vs despair	Infancy and early child hood .the chlld begin learn to walk,take foods, talk, eliminate Middle child hood . the child learn reading, learn values Adolescence .begin to show relationship Emotional stability Early adult hood The person begins choose life partner, family, occupation Middle age Begin to express responsibilities and relation with life partner Late maturity Learn to cope with decreased health Retirement, loss of life partner

                

5. Conditions that affect growth and developmental at all ages

There are many conditions that affect the growth and developmental at all ages which are

· Hereditary is the factor that affects the growth and development at all stages. An individual derives most of the disease from the ancestral parents

· Environment is the factor that affect the growth and developmental of person. Physical and psychosocial environment influence a person’s development. A person lives in a good environment gets better growth and development than one who has not

· Sex: the boys have more power and stronger than females. Their physical characteristics are different from other one.

· Hormones: hormones are the factor influence growth and development of a person. Hormones are secreted by the endocrine glands and control the behavior, growth, obesity and other disease. Boys and girls begins to show sexual characteristics during puberty

· Influence of family: when person lives in good loving environment, their growth and development would be better. If the person is not lived in good familiar support, their growth and development would get affected such as poor social skills, decreased bonding, unable to cope with difficulties.

6. Cognitive and psychosocial changes in sickle cell disease

· The child begins to show anxiety and depression beacuse of the disease

· They tend to withdraw from society and lives alone

· They show decreased school performance because of the changes in the body and decresed oxygen and nutrition to the brain.

· They decrease their relationship with peers because of their decreased growth

they show aggressive behaviour because of their incapability

7. The child is assessed height, weight, mid arm circumference, chest circumference, growth chart maintaining. Because their growth and development can be affected because of sickle cell anemia. Generally, Patient can be assessed for the pain and its quality, intensity and type of pain. They are intolerable to pain. It affects their mobility and tends to remain in a place. Oxygen saturation is monitored. Laboratory test such as hemoglobin electrophoresis, peripheral smear test to find out the hemoglobin shape, liver function test, renal function test in order to find out the jaundice due to increased bilirubin and renal excretion of red blood cells and cause damage the kidney and hemoglobin test are done to diagnose the condition.

8.. The treatment of the sickle cell disease is depend on the age, health of the children. The infants does not show symptoms until 6 months of age because of mother hemoglobin is circulated in infants

· Child are treated with pain medication if he has pain

· Child are advised to drink 6-8 glasses of water

· Child is administered with blood transfusions in case of spleenic involvements, anemia, log term pain

· Vaccines and antibiotic can be prescribed in order to treat infection. because of spleenic damage by stickled RBC

· Regular physical examination every year

· Hydroxyurea is used to treat the sickle cells in the blood. It is given 5mg/kg/day

For infants and toddlers

Ø The child can be managed with penicillin and 250mg is divided and is given twice a day

Ø Folic acid can be given in order to make the red blood cells

Ø Acetaminophen is prescribed to treat pain

Ø Immunization is given according to schedule. In addition child Is immunized with flu vaccine after 6 months of age

Ø Pneumovax can be given in order to prevent the pneumonia and other infection

School and teenage children:

Ø Encourage them to play activities mainly moderate activity instead of strenuous activity

Ø Explain them to use separate bottle water to drink in outside

Ø Maintain a hygiene practice in each activities

Ø Advise them to restrict activities during winter and summer seasons

9. Child begins to show changes in developmental tasks. There 5 domains of developmental principles in caring for patient with sickle cell anemia. They are physical, cognitive, language, social and emotional domains.

        Physical domain:

Ø child is monitored for weight, height, body mass index, growth monitoring

Ø the child is encouraged to drink more water to reduce pain

Ø Child is advised to eat drink of variety of foods such as fruits and vegetables and contain proteins mainly I foods should contains vitamin A, Vitamin C, vitamin C and folic acid.

Ø The child is encourage to do exercise moderately

Ø Monitor the patient pain frequently using pain scale

Ø Patient pain can be treated with pain medication in order to relieve pain

                  Cognitive development, language, behavior, and emotional development:

Ø Provide relaxation therapy in order to produce the relaxation

Ø Motivate them to involve in peer groups

Ø The pain can be relieved by use distraction therapy

Ø Help them to plan their activities in order to improve coping skills

Ø Advise them to avoid activities in case of summer and winter season

Ø Advise to continue medication in order to avoid side effects

Ø Assess the patient cognitive function in order to identify any infarcts

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