Sickle Cell Anemia And Nursing Care Plan

Sickle Cell Anemia

Anemia is deficiency in the:

  • Number of RBC’s (erythrocytes)
  • The quantity of Hemoglobin (Hb)
  • The volume of packed RBC (Hematocrit)

STRESSORS

PHYSIOLOGICAL:

  • Heredity
  • Haemorrhage – trauma, bleeding peptic ulcer, heavy menstrual flow.
  • Reduced RBC production – diet: inadequate intake of iron, protein, vit.B12. Absence of intrinsic factors.
  • Excessive RBC destruction: Blood incompatibility, Thalassemia.

DEVELOPMENTAL:

Age group—late adult.

Sex-m (hemophilia); F (menorrhagia).

Race—black Americans, Indians, middle East

SOCIOCULTURAL:

Diet habits.

 

Anemia Diagnostic tests

  • CBC- total no. of each cell.
  • WBC and differentials — total no. of WBC and no. of each cell.
  • Hgb—men 14-18g/dl, women 12-16g/dl
  • Platelet count —150,000-350,000/100ml of blood.
  • Hematocrit – packed cell volume (PCV).
  • Hgb –electrophoresis -sickling test
  • Bone marrow puncture — bone marrow is removed from the sternum with a needle and the no. of cells are examined.

Nursing responsibility

  • Anaesthesia is given. After the test, apply pressure dressing. Check for bleeding.

 

SICKLE CELL ANEMIA:

SICKLE CELL ANEMIA

  • Genetic blood disorder
  • Hgb forms lumps in RBC. RBCs form sickle shape (cannot move thru smaller blood vessels

Predisposing Factors:

  • Low O2 from high altitude or strenuous exercise
  • Anaesthesia
  • Dehydration
  • Acidosis

Sickle cell anemia is an inherited disorder in which abnormal hemoglobin (the red pigment inside red blood cells) is produced. The abnormal hemoglobin causes red blood cells to assume a sickle shape, like the ones seen in this photomicrograph.

 

Common reactions for Sickle Cells

  • Pallor
  • Lethargy
  • Swelling and pain in the joint
  • Decrease urinary output
  • Abdominal or chest pain
  • Tarry, coffee ground stool
  • Swollen lymph nodes
  • Weakness
  • Irritable
  • Mental depression
  • Difficulty concentrating
  • Dark urine- brownish

 

Sickle cell crisis (complication)

  • Upper respiratory infection
  • Vasoocclusion-clumps of RBC
  • Obstruct blood vessels
  • Severe joint pain, abdominal pain and pain and swelling of hands and feet.

Affected Organs :

  • Brain-headache, dizziness, convulsion.
  • Lung—SOB, coughing.
  • Kidney—reduced urine.

Effects of sickle cell anaemia

  • Brain –stroke
  • Heart failure.
  • Gall bladder stone
  • Renal failure
  • Hemathrosis -bleeding into joints.

 

Management for sickle cell disease

  • Hydration -IV fluids
  • Bed rest
  • Analgesics -morphine
  • Oxygen
  • Blood transfusion
  • Antibiotics
  • Bone marrow transplant

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