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 Justice has been less verbal, withdrawn, having trouble sleeping, and often crying while hospitalized.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.

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