FSU response
Please respond to discussion
Consequently, at this early developmental stage of a kid, the goals of treatment techniques would be to prevent infections, prevent dehydration, and relieve acute pain. Notably, one of the most important factors at this point is dehydration, which can make SCA-related pain episodes worse. I would therefore make sure the patient drinks a lot of fluids. In addition, I would prescribe penicillin as a lifetime treatment to ward off deadly illnesses like pneumonia. More significantly, I would make sure the patient has received all necessary vaccinations, including the meningococcus and Hib vaccines, for newborns up to eight weeks of age. In addition, I would inform the parents about the importance of routine check-ups, the connection between genetics and the pathophysiology of the condition, and the potential results of treatment at each developmental stage (Colombatti et al., 2021). Managing the patient will require ongoing care and observation for life. As such, the formation and management of a multidisciplinary care team involving pediatric physicians, interventional radiologists, pediatric oncologists, and primary care providers (PCPs) will be required. Because parents and caregivers find it difficult to comprehend and accept the illness, the multidimensional nature of hemoglobin-related syndrome in babies is a critical concern (Colombatti et al., 2021). If this patient needed a heart operation, stem cell transplant, blood transfusion, or any other major surgical procedure, I would refer them to a pediatric specialist, such as an oncologist or surgeon.
2 Years
While doctors assist in treating medical conditions, radiologists can also help by conducting limb ultrasounds to rule out vein thrombosis, abdominal ultrasounds to check for spleen or liver enlargement, and chest X-rays to determine structural heart impairment. Further treatments consist of giving analgesics, antioxidants, folic acid supplements, and meals high in calcium, folate, magnesium, and vitamins A, C, and E (John et al., 2020). Furthermore, it’s critical to confirm that the patient has gotten all recommended childhood immunizations up to the age of eighteen months as well as the related booster shots spaced five years apart. The potential of increased infection recurrence, particularly with respiratory tract infections, would be a major concern in this case.
6 Years
SCA symptoms and incidences typically peak between the ages of 4 and 6. I would give hydroxyurea to raise fetal and general hemoglobin levels to lower the frequency of the excruciating episodes, the requirement for hospitalization, and the necessity for blood transfusions as a result. At this point, a potent analgesic, such Tylenol, would be required, however this would mostly depend on how bad the pain was (John et al., 2020). In addition, I would make sure the youngster has the Covid-19 vaccination and booster at this age and inform the parents of the significance of making sure the patient takes the appropriate pandemic measures. Given the higher frequencies and severity of the symptoms, incidences of pain crises would be a significant concern in this situation.
13 Years
The patient will be entering puberty at the age of 13, which will be difficult because SCA is a chronic illness. Initially, I would suggest that patients with SCA who 12 years of age are or older be prescribed the oral drug Voxelotor (Howard et al., 2021). To help boost the amount of healthy red blood cells and lower the risk of stroke, I would also think about receiving blood transfusions. The teen’s strong desire for privacy and unwillingness to attend health care facilities due to the linked disease’s influence on their physical appearance are potential concerns at this period (Inusa et al., 2020). To improve openness, though, I would suggest sending them to an adolescent support group. In addition, I would inform the parents about the major, delicate concerns related to this phase, such as the risk of stroke and the potential for gallstones to postpone puberty. If the patient is male, urologist consultation is required due to the possibility of ischemic priapism.
How would you coordinate the care of this child?
The child’s care plan should be customized to match his unique needs through long-term therapy and monitoring because he has been diagnosed with a chronic, occasionally fatal disease. Such a scenario, according to Ozturk et al. (2021), calls for rigorous parent education and assistance, well monitored growth, and immunization schedules that are appropriately followed. Therefore, in my capacity as the primary care physician leading the patient’s care coordination, I would advise forming a multidisciplinary team with qualified experts who represent a range of cultural backgrounds. As a result, I would implement an evidence-based consulting and informational service structure to guarantee efficient interspecialty collaboration. To do annual ophthalmologic exams, for instance, a retinography professional would need knowledge and consultation (Ozturk et al., 2021). Comprehensive care delivery, from healthy child conditions to acute care to hospitalizations and thorough follow-up, is ensured by an efficient interprofessional teamwork.
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