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Unformatted text preview: lood cell; insufficient oxygen causes
the cells to assume a sickle shape and the cells become rigid and clumped together, obstructing capillary blood flow. Therefore,
oral and intravenous fluids are an important part of treatment. Meperidine (Demerol) is not recommended for the child with
sickle cell disease because of the risk for normeperidine-induced seizures. Normeperidine, a metabolite of meperidine, is a
central nervous system stimulant that produces anxiety, tremors, myoclonus, and generalized seizures when it accumulates with
repetitive dosing. The nurse would thus question the order for restricted fluids and meperidine for pain control. Positioning for
comfort, avoiding strain in painful joints, oxygen, and a high-calorie, high-protein diet are also important parts of the treatment
176. vonWillebrand disease
von Willebrand disease is a hereditary bleeding disorder characterized by a deficiency of or a defect in
a protein termed von Willebrand factor (vWF). The disorder causes platelets to adhere to damaged endothelium. It is
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This document was uploaded on 03/29/2014.
- Spring '14