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Anemia
Definition
Sickle cell anemia is a
disease passed down
through families in which
red blood cells form an
abnormal crescent shape.
Causes/Etiology
Sickle Cell Anemia is an inherited disorder in which a child
inherits one abnormal gene from each parent. This is known as
autosomal recessive inheritance.
Risk Factor
NON MODIFIABLE
1.
Hereditary
2.
Race
Delayed growth
RBCs provide your body with the oxygen and nutrients you need
for growth
Shortage of healthy red blood cells can slow growth in infants and
children and delay puberty in teenagers
Jaundice
It is a yellowing of the skin and eyes that occurs because of liver
damage or dysfunction
Sickle cell anemia have some degree of jaundice because the liver,
which filters harmful substances from the blood, is overwhelmed by the
rapid breakdown of red blood cells
Hand-foot syndrome
Swollen hands and feet may be the first
signs of sickle cell anemia in babies. The
swelling is caused by sickle-shaped red
blood cells blocking blood flow out of their
hands and feet.
Frequent infection
Sickle cells can damage your spleen, an
organ that fights infection. This may make
you more vulnerable to infections.
Diagnostic Test
Test
Definition
Hemoglobin
Hemoglobin
electrophore
electrophoresis sis is a test
that
measures
the different
types of the
oxygencarrying
substance
(hemoglobin
) in the
blood.
Purpose
You may
have this
test if your
health care
provider
suspects
that you
have a
disorder
caused by
abnormal
forms of
hemoglobin
Normal
result
Abnormality
with
condition
No HbS
Presence of
HbS
A sickle
Sickle Cell
cell test
Test
looks for
the
presence
or
absence
of
abnormal
hemoglob
in in the
blood that
causes
sickle cell
anemia.
This test
is done to
tell if you
have
abnormal
hemoglob
in that
causes
sickle cell
disease
and sickle
cell trait.
Negative
Sickle
Cell Trait
Sickle
Cell
Anemia
Complete
Blood
Count
(CBC)
-It measures
the # of
RbCs, # of
WBCs, total
It is a
amount of
screening
Hb in the
test used to
blood, % of
diagnose
the blood
and manage
composed of
numerous
RBCs(hemat
diseases.
ocrit)
-provides
specific
information
the size and
hemoglobin
content of
individual
red blood
cells.
RBC:
Male:
4.7 to
6.1million
cells/mcL
decrease
(indicates
Female: 4.2
to 5.4 million
cells/mcL
WBC:4,500
to 10,000
cells/mcL
anemia)
Hgb:
Male:
13.8 to
17.2 gm/dL
Female:
12.1 to 15.1
gm/dL
Chronic
neutrophili
a is often
present
Platelets:
1500,000400,000/L
decrease
5-10g/dL
often
increase
Nursing Management
Provide information about what the client may feel
Encourage questions and dialogue about fears and apprehensions
Inform the client of the time period before the results will be available
Management
Medical
Patients with sickle cell disease need ongoing treatment, even when they
are not having a painful crisis.
1.
Acetaminophen
Classification: Analgesic
Action: It is used for the relief of fever as well as aches
and pains associated with many conditions.
Indication: Mild Pain/ Fever
Generic (Brand) names: Acetaminophen( Tempra, Tylenol)
2.
Hydroxyurea
Classification: Antimetabolite
Action: inhibits production of Hb F, which inhibits sickling
Indication: to reduce frequency of painful crises and
need for blood transfusions in adult
recurrent
crises
3.
Blood Transfusion
In a red blood cell transfusion, red blood cells are
4. Supplemental oxygen
Non Pharmacological-Highlights
1.
2.
Fluids
-help prevent dehydration
- given either by mouth or through a vein
3.
Heating pads
Surgical
Bone marrow transplant
This procedure replaces bone marrow affected by sickle cell
anemia with healthy bone marrow from a donor who doesn't have
the disease. It can be a cure, but the procedure is risky, and it's
difficult to find suitable donors.
Bone marrow used for a transplant must come from a closely
matched donor. This is usually a close family member who doesn't
have sickle cell anemia.
Bone marrow transplant requires a lengthy hospital stay. After
the transplant, you'll need drugs to help prevent rejection of the
donated marrow.
Nursing Diagnosis
Diagnosis: Acute pain related to tissue hypoxia
Interventions:
-promote calm and relaxing environment to divert clients
awareness to pain
-divertional activities like watching television, use of imagery etc.
-perform warm compress on the site of pain to provide relief
-encourage families to maintain a normal life for the child with SC
Anemia
Outcome: Client will be able to relieve pain.
Prognosis
In the past, sickle cell patients often died from organ failure
between ages 20 and 40. Thanks to a better understanding and
management of the disease, today, patients can live into their 50s
or beyond.
Causes of death include organ failure and infection. Some
people with the disease experience minor, brief, infrequent
episodes. Others experience severe, long-term, frequent episodes
with many complications.
Research
Red grape skin may help sickle cell sufferers(October 31, 2009)
"AUGUSTA, Ga. An extract in red grape skin may be a new treatment for
sickle cell disease, Medical College of Georgia researchers say.
Study Using Viagra Ingredient to Treat Sickle Cell
Cut Short (July 28, 2009, 2:03 PM)
References
Brunner and Suddaraths Textbook of Med-Surgical Nursing 11th
Edition
Kozier ans Erbs Fundamentals of Nursing
Tabers Cyclopedia Medical Dictionary, F.A. Davis
Disease and disorders Nursing Therapeutic Manual
Http://en.wikipedia.org/wiki/Sickle_Cell_Disease
http://www.nlm.nih.gov/medlineplus/ency/article/000527.htm
http://www.mayoclinic.com/health/sickle-cell-anemia/DS00324
Nursess Pocket Guide 11th Edition