NSG 3800 & 3850 Exam 1 Review Topics Galen College of
Nursing Questions With Complete Solutions
Sickle Cell Anemia
a genetic disorder that causes abnormal hemoglobin, resulting in
some red blood cells assuming an abnormal sickle shape
What does sickle cell anemia cause?
Abnormal shape of RBCs can cause decreased oxygenation
(because of the shape they can carry oxygen as efficiently).
They can also cause occlusions in blood vessels, resulting in
pain.
What are the expected lab values for sickle cell anemia?
Hemoglobin and Hematocrit will be chronically low, however,
when dehydrated they will create a 'false' increase in values.
Bilirubin will increase.
WBC & Platelet will be higher (referred to as a chronic
inflammatory state)
sickle cell anemia clinical manifestations & expected findings?
Joint Pain
Fatigue
,Tachycardia/Murmurs/Cardiomegaly (big heart)
Jaundice (Due to excess bilirubin)
Low O2 Saturation
HEADACHE THAT WON'T SUBSIDE
Why does sickle cell anemia cause higher levels of bilirubin?
Sickle cell patient's RBCs do not have as long as a life span as
normal RBCs, therefore they are dying out faster than the liver
can filter them out.
sickle cell crisis: Acute Vaso-Occlusive Crisis
Entrapment of erythrocytes & leukocytes leading to tissue
hypoxia, inflammation, and necrosis. It is VERY painful.
Sickle cell crisis: Acute Chest Syndrome
This is the leading cause of death in patients with sickle cell.
a severe lung-related complication of sickle cell disease that
affects both children and adults. It creates a pneumonia like
illness.
Sickle cell crisis: Aplastic Crisis
Results from the human parvovirus.
Hemoglobin levels will fall rapidly and bone marrow cannot
compensate, AS EVIDENCE BY THE ABSENCE OF
RETICULOCYTES (immature RBCs)
Sickle cell crisis: Sequestration Crisis
, Results when organs pool the sickled cells. Can effect the liver,
spleen, and LUNGS.
Complications of Sickle cell disease?
Stroke, Kidney/liver Failure, HF, Pulmonary HTN, Acute Chest
Syndrome, Infection, & Reproductive Issues.
remember these patients are at risk for occlusions in blood
vessels.
Sickle Cell Nursing Interventions
H.ydration
O.xygenation
P.ain Management
Keep the patient warm. Cold temperatures can send these
patients into a crisis.
YOU NEED AN ORDER TO GIVE PRN BREAKTHROUGH
PAIN MEDICATIONS.
Sickle Cell Nursing Care
educate on PCA pump, incentive spirometry.
Cluster care as much as possible.
Allow patients to take breaks during activities.
Infection prevention: Hand hygiene & Antibiotic Prophylaxis
Sickle Cell Medical Management
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