No abstract

Pain related to vasoocclusion is the most common reason for emergency department visits and hospital stays among pediatric patients with sickle cell disease. Using a prospective descriptive design, patients hospitalized with sickle cell pain were asked to complete the Adolescent Pediatric Pain Tool on each day of their hospital stay, providing data on the location, intensity, and quality of their pain. Data for 82 hospital stays were collected from 40 African American study participants. Mean age was 14.8 years, and mean length of stay (LOS) was 5.1 days. Mean LOS for 8 to 12 year olds (3.23 days; n = 22) was shorter than mean LOS for 13 to 19 year olds (5.85 days; n = 60). This LOS difference was significant (P = .004). Difference in LOS by gender was not significant. Higher initial number of body sites with pain was significantly associated with longer LOS (r = .39; P < .001). Higher initial pain intensity scores were significantly associated with longer LOS (r = .37; P = .001). Higher initial number of word descriptors was only weakly associated with longer LOS. Neither gender nor age differences were significant for Adolescent Pediatric Pain Tool data.

Pleuropulmonary blastoma (PPB) is a dysontogenetic neoplasm of childhood that involves lung and/or pleura. There is an increased incidence of neoplasias and dysplasias among young relatives of children with PPB. Pathophysiologically, PPB evolves from a cystic to solid state over time. It is subclassified as type I (purely cystic), type II (both cystic and solid elements), and type III (completely solid). Type II and type III may be associated with metastasis, with the brain being the most common metastatic site. The absence of epithelial malignancy in PPB is a feature that distinguishes it from the adult-type pulmonary blastoma. The clinical presentation includes signs and symptoms associated with various respiratory disorders. To make a definitive diagnosis of PPB, an examination of the cystic fluid or solid tumor is required. Treatment for PPB consists primarily of surgery and chemotherapy. Nursing care is directed toward maintaining normal respiratory and neurological function, maintaining normal fluid and electrolyte balance, minimizing side effects associated with treatment, and providing education for the family.