As a nurse, I had the opportunity to care for a young adult with sickle cell anemia during hospital admission. The patient was experiencing frequent painful crises, requiring pain management and continuous monitoring. I was able to give education on managing triggers and maintaining hydration status.
The patient gradually was getting better during their stay and really wanted to make a better change when they went home knowing how much this had impacted their life. I was happy to be part of their care that day.
1. A hereditary disorder that primarily affects African Americans by a recessive trait
a. If both parents are carriers there is a 25% of their offspring having SCA, 50% chance of being a carrier, and only a 25% chance of no inheritance
1. The genetic mutation leads to rigid, misshapen RBCs
a. Affects hemoglobin’s ability to carry oxygen and the misshapen RBCs get stuck within the blood vessels, causing an obstruction
2. Can lead to Sickle Cell Crisis – 2 kinds
a. Micro-occlusions → Vasoocclusive Crisis
i. ↓ Blood flow to tissue = hypoxia, ischemia, infarction
1. Joint pain
2. Stroke
3. Acute Chest Syndrome
ii. Sequestration
1. Pooling of blood
2. Usually in the spleen
b. Acute Exacerbation
i. Caused by hypoxia, exercise, high altitude, fever, temperature extremes
1. Pallor and fatigue
2. Severe Pain
a. Due to micro-occlusions→ Symptoms match the location of the occlusion
1. Hemodilution
a. Dilute blood to ‘wash out’ sickled cells
b. Give IV Fluids for hydration
c. Blood transfusions → give properly shaped/functioning RBCs
2. Oxygen Supplementation
a. Increase oxygen delivery to the tissues if the client is hypoxic!
3. Pain Relief→ This pain is severe
4. Hydroxyurea
a. A medication used for clients with a history of frequent crises
b. Shown in infants to increase the potential for preserving fetal hemoglobin (a form of Hgb plentiful in gestation), which increases the availability of oxygen to the tissues, thereby reducing complications of SCD
Medical History:
Mr. Williams had a known medical history of sickle cell anemia, an inherited blood disorder
Diagnosis:
Mr. Williams was diagnosed with sickle cell anemia, a genetic condition causing abnormal hemoglobin formation, resulting in sickle-shaped red blood cells.
Treatment Plan:
Outcome:
With attentive nursing care and the implementation of the treatment plan, Mr. Williams experienced improved management of sickle cell crises and associated symptoms. Blood transfusions and pain management measures provided relief during acute episodes, and counseling on lifestyle modifications empowered him to manage his condition better.
This Sickle Cell Anemia review provides essential knowledge for confidently approaching the NCLEX. Understanding its prevention, management, and interventions empowers nurses to provide adequate care and save lives.
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