{"id":48050,"date":"2022-04-02T20:36:53","date_gmt":"2022-04-02T20:36:53","guid":{"rendered":"https:\/\/assignmenttutors.net\/blog\/?p=48050"},"modified":"2022-04-02T20:36:53","modified_gmt":"2022-04-02T20:36:53","slug":"sickle-cell-anemia-concept-case-analysis","status":"publish","type":"post","link":"https:\/\/assignmenttutors.net\/blog\/sickle-cell-anemia-concept-case-analysis\/","title":{"rendered":"Sickle Cell Anemia- Concept Case Analysis"},"content":{"rendered":"

Concept Case Analysis \u2013 NUR 401
\nAnemia – Sickle Cell Anemia
\nCase Study
\nCLIENT PROFILE
\nJoan is a 55-year-old black American who presents to the emergency department with complaints of
\nchest pain and some shortness of breath. Joan indicates that she has had a non-productive cough and low\u0002grade fever for the past two days. She recognizes these symptoms as typical of her sickle cell crisis episodes
\nand knew it was important she come in to get treatment. She has a past medical history of high cholesterol,
\nand hypertension.
\nCASE STUDY
\nJoan was diagnosed with sickle cell anemia at the age of 6 years. She has had multiple crises requiring
\nhospitalization. She states that the pain in her chest is an \u201c8\u201d on a 0 to 10 pain scale. She describes the pain as
\na \u201cconstant burning pain.\u201d Her vital signs are temperature of 38.2 degrees Celsius, blood pressure 140\/90,
\npulse 96 bpm, and respiratory rate of 25. Her oxygen saturation on room air is 90%. She is having some
\ndifficulty breathing and is given 3 liters of oxygen by nasal cannula. Joan explains that she took Extra Strength
\nTylenol for the past two days in an effort to manage the pain, but when this did not work and the pain got
\nworse, she came in for a stronger pain medication. She explains that in the past she has been given morphine
\nfor the pain and prefers to use the patient-controlled analgesia (PCA) pump. Other routine medications
\ninclude: Ramipril 5 mg po OD, Atrovastatin 10 mg po qhs.
\nJoan is admitted for pain management, antibiotic treatment, and respiratory support. The physician\u2019s orders
\ninclude:
\nCBC (film and differential) Reticulocyte count Blood cultures
\nABG\u2019s CXR Cross type and match
\nTitrate O2 to keep saturation > 92% Cefuroxime 1 gm q8h IV Ramipril 5 mg po OD
\nPCA Morphine 30mg over 4 hours IV Lactated Ringers @ 100cc\/hr Atrovastatin 10mg po qhs
\nBlood work reveals the following values:
\nwhite blood cell count (WBC) 18,000 cells\/L
\nred blood cell count (RBC) 3 x 106
\nhemoglobin (Hgb) 75 g\/L
\nhematocrit (Hct) 0.218
\nreticulocyte count 23%
\nBlood Cultures Results pending
\nABG\u2019S
\npH 7.54
\nPaCO2 32
\nHCO3 22<\/p>\n

 <\/p>\n

Questions<\/p>\n

    \n
  1. Discuss the relationship between sickle cell anemia and a client\u2019s ethnicity. Does Joan\u2019s ethnicity play a role in her diagnosis? If so. How and why? (3 points)<\/li>\n<\/ol>\n

    ANS:<\/p>\n

      \n
    1. Discuss the pharmacologic management for a client with sickle cell anemia. Discuss the potential adverse effects of the medication (5 points)<\/li>\n
    2. Describe the use of transfusion therapy for the management of sickle cell anemia. Discuss the potential complications of chronic red blood cell transfusions. (5 points)<\/li>\n
    3. Bone marrow transplant (BMT) offers a potential cure for sickle cell disease. Why is BMT a treatment option available to only a small number of clients with sickle cell disease? Would Joan be a candidate for BMT? Why or why not? (3 points)<\/li>\n
    4. a) Discuss the symptoms the nurse should assess while completing a head-to-toe assessment of a client in potential sickle cell (yaso-occlusive) crisis.<\/li>\n
    5. b) What diagnostic and lab tests should be ordered for a client with sickle cell anemia and ii) state why for each (10 points)<\/li>\n
    6. Discuss how Joan\u2019s lab results are consistent with clients who have sickle cell anemia. Discuss at least 3 of the abnormal lab values provided.<\/li>\n
    7. Identify three priority potential nursing problems appropriate for Joan and a potential cause for each (3 points)<\/li>\n
    8. Describe the nursing management goals (at least 5) during the acute phase of sickle cell crisis (10 marks – must identify goals based upon the problems that are associated with acute phase and describe it – not just list them)<\/li>\n
    9. Need<\/li>\n
    10. There are four common patterns of an acute vaso-occlusive sickle bone crisis, acute chest syndrome, abdominal crisis and joint crisis. Briefly describe the characteristics symptoms of each pattern. Which pattern is most congruent with Joan\u2019s presenting signs and symptoms?<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

      Concept Case Analysis \u2013 NUR 401 Anemia – Sickle Cell Anemia Case Study CLIENT PROFILE Joan is a 55-year-old black American who presents to the emergency department with complaints of chest pain and some shortness of breath. Joan indicates that she has had a non-productive cough and low\u0002grade fever for the past two days. She […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[41],"tags":[],"class_list":["post-48050","post","type-post","status-publish","format-standard","hentry","category-nursing-healthcare-medicine-nursing"],"_links":{"self":[{"href":"https:\/\/assignmenttutors.net\/blog\/wp-json\/wp\/v2\/posts\/48050","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/assignmenttutors.net\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/assignmenttutors.net\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/assignmenttutors.net\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/assignmenttutors.net\/blog\/wp-json\/wp\/v2\/comments?post=48050"}],"version-history":[{"count":2,"href":"https:\/\/assignmenttutors.net\/blog\/wp-json\/wp\/v2\/posts\/48050\/revisions"}],"predecessor-version":[{"id":48053,"href":"https:\/\/assignmenttutors.net\/blog\/wp-json\/wp\/v2\/posts\/48050\/revisions\/48053"}],"wp:attachment":[{"href":"https:\/\/assignmenttutors.net\/blog\/wp-json\/wp\/v2\/media?parent=48050"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/assignmenttutors.net\/blog\/wp-json\/wp\/v2\/categories?post=48050"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/assignmenttutors.net\/blog\/wp-json\/wp\/v2\/tags?post=48050"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}