Question

Scenario

Justice is a 13-year-old black female with sickle cell anemia. She was admitted in sickle cell crisis and has been having joint pain rated at 6-8/10 on Numerical Rating Scale much of the time. Her BP and pulse rate remain elevated. Justice has a cognitive development delay and behaves as an 8-year-old in many situations. She was diagnosed with sickle cell at birth. Justice has been less verbal, withdrawn, having trouble sleeping, and often crying while hospitalized. She is asking for her mother frequently.

She lives with her maternal grandparents, two parents, her siblings, 5 and 15 years of age, and her pet dog. Her mother is on active duty with the service and has been out of country for 9 months; her father runs a local hardware store. Justice has seen her older sibling go through significant pain with sickle cell crisis over the years and the sibling was admitted in similar situation with crisis one year ago.

Initial Discussion Post:

Consider the scenario, and address the following:

1. Identify at least three (3) factors that influence Justice’s pain/discomfort perception.
2. Describe the patient's physiologic OR psychosocial responses to pain/discomfort.

Provide thorough explanations for each answer.

Answer 1

3 FACTORS THAT INFLUENCE JUSTICE'S PAIN / DISCOMFORT PERCEPTION :

1. MEDICAL CONDITION : As Justice is diagnosed with Sickle Cell Anemia, which is a serious problem in which red blood cells become rigid and the transportation of RBC is not possible in a normal way. it leads to decrease of RBC in blood causing sickle cell anemia. Due to this condition she is having severe joint pain, which is one of the risk factor that influence pain.

2. YOUNG AGE (13 YEAR OLD) : Justice is just 13 years old. She needs support from her family, especially her mother. But her mother is in active service and is away from her since 9 months. This creates an emotional disturbance in her, as she is admitted in hospital for treatment of disease and needs her mother seated along with her. Due to the absence of her mother she felt lonely and this is also one factor that influence pain.

3. SUFFERING BY SIBLING : Justice has seen her sibling affected with the same condition and admitted in the hospital one year ago with suffering and pain. That also affects on her and produce emotional disturbances which elevates pain more than the normal.

PATIENT'S PHYSIOLOGIC OR PSYCHOLOGICAL RESPONSES TO PAIN/ DISCOMFORT :

PHYSIOLOGIC RESPONSES TO PAIN : Pain is one of the fifth vital sign which affects :

*Increased heart rate

*Increased pulse rate

*Increased respiration

*Increased blood pressure

*Changes in body temperature

*Profuse sweating

*Poly urea due to excessive stress

*Dilation of pupils

PSYCHO SOCIAL RESPONSES TO PAIN :

*Changes in emotional balances

*Anger

*Anxiety

*Depression

*Crying

*Misunderstanding

*Demoralization of thoughts, perceptions

*Avoidance from society