Case Study Sickle Cell Disease

1. Sickle cell disease is a group of disorders that affects hemoglobin, the molecule in red blood cells that delivers oxygen to cells throughout the body. People with this disorder have atypical hemoglobin molecules called hemoglobin S, which can distort red blood cells into a sickle, or crescent, shape. SCD affects millions of people worldwide, particularly those with African, Spanish, Mediterranean, and Indian ancestry.

Some 120,000 infants are born with SCD every year worldwide. In the United States, approximately 1 in 500 African-Americans and 1 in 1,200 Hipic Americans are born with SCD. Some 2 million Americans including about 10 percent of the African-American population carry one gene for SCD, the “sickle cell trait.” 2. People without a spleen or those who have a spleen that is nonfunctioning are at an increased risk for developing infections, these infections can be fatal if not treated immediately.

3. Anemia resulting from a failure in blood cell

Anemia associated with an excessive destruction of red cells

4. SCD can be very painful and to help control the pain the physican would need to know how much pain the client is in and if he is in pain did he want something to help control the pain.

5. Yes V.M. is be adequately oxygenated.

6. V.M. low Hgb could be causing the S.O.B. usually shortness of breath with anemia is caused upon exertion so I think there are some other underlying conditions causing his SOB.

7. Increased pulse, crackles in the lungs, increased B/P, increased respirations/respiration pattern.

8. I would expect the MD to do a chest xray, place client on strict I&O, give him lasix, admit for observation, order teds, place on low sodium diet.

9. Normal
NA 137
K 4.9
WBC 4.3
Platelets 208

High
Bun 27

Creatinine 2.7- problem with the kidneys or kidney function
Phospate 4.7- controlled by kidneys, evidence of a kidney problem Cl 110- can be caused by certain kidney disease

Low

CO2 16 Changes in your CO2 level may suggest that you are losing or retaining fluid, which causes an imbalance in your body’s electrolytes.CO2 levels in the blood are influenced by kidney and lung function. The kidneys are mainly responsible for maintaining the normal bicarbonate levels. Ca 8.2- kidney decease can cause a decrease in Ca

HBG 7.8 can be caused by Kidney problems, SCA, bleeding etc
Hct 20.9 can be cause by anemia, destruction of red blood cells and over hydration

10. Furosemide – Furosemide is a loop diuretic (water pill) that prevents your body from absorbing too much salt, allowing the salt to instead be passed in your urine. Furosemide treats fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome. This medication is also used to treat high blood pressure (hypertension). Methylprednisolone – is used to treat conditions such as arthritis, blood disorders, severe allergic reactions, certain cancers, eye conditions, skin/kidney/intestinal/lung diseases, and immune system disorders. It decreases your immune system’s response to various diseases to reduce symptoms such as swelling, pain, and allergic-type reactions. This medication is a corticosteroid hormone.

Ceftriaxone is an antibiotic used to treat a wide variety of bacterial infections. This medication is known as a cephalosporin antibiotic. It works by stopping the growth of bacteria. 11. Sickle Cell Disease clients often receive blood transfusions on an ongoing basis, making it more important for the them to receive the best match for their bodies. When they receive blood that is not the best match, their bodies may begin to slowly reject the blood.

If they cannot receive blood safely, they may die. It is important that the labs knows it is a sickle cell patient, follow all facility protocols ( monitoring Bp, temp, pulse, as recommended), monitor the patient closely for signs and symptoms of rejection. 12. Often SCD patients are looked at as drug seekers and are not provided with the pain relief that they need. It’s important to remember not to stereotype patients and believe what they tell you their pain level is.

13. Have him follow up with a cardiologist about his heart murmur, incourge hime to work on his B/P control with diet and exercises. Education on what can trigger Sickle cell crisis temp, smoking etc. Encourage a low sodium diet, weigh daily if more than a 2 lbs gain in a day notify his physician, Teach causes of fluid volume excess and/or excess intake to patient or caregiver. Provide information as needed regarding the individual’s medical diagnosis (e.g., congestive heart failure [CHF], renal failure). Explain or reinforce rationale and intended effect of treatment program. Identify signs and symptoms of fluid volume excess. Explain importance of maintaining proper nutrition and hydration, and diet modifications. Identify symptoms to be reported.