T11: Sickle Cell & DIC

Question 1

sickle cell anemia

Answer 1

sickled appearance of RBCs do not allow O2 to be carried; autosomal recessive trait, tested at birth, life expectancy shortened

Question 2

clinical manifestations for sickle cell

Answer 2

o PAIN (usually caused due to ischemia)
§ Chronic and acute in simultaneous areas
o VS changes fever, swelling, tachypnea,HTN, NV
o Anemia hemolysis, pallor (check mucus membranes), jaundice
o Organ damage kidney, liver, spleen, brain, bones

Question 2

sickle cell crisis clinical manifestation

Answer 2

o Severe pain
o Tissue hypoxia
o Increased capillary permeability-edema
o Hypovolemia
o Shock

Question 2

intervention for sickle cell

Answer 2

HOP
-HYDRATION: ISOTONIC FLUID 0.9% NS
o Maybe even a transfusion because RBCs may be normal but they may be SICKLED
-OXYGEN
-PAIN RELIEF
o Possibly through PCA pump
o High high doses of pain medications

Question 3

prevention of sickle cell crisis

Answer 3

-no high altitude
-stay hydrated
-treat infection properly
-dont add extra stress to body
-immuizations
-eye and vision screening

Question 4

pain management for sickle cell

Answer 4

· Morphine, hydromorphone
· Adjuncts-NSAIDS, antineuropathic, locals, nerve blocks

Question 5

Hydroxyurea

Answer 5

oral agent to suppress sickle cell

Question 6

HEMATOPOIETIC STEM CELL transplant

Answer 6

IS THE ONLY CURE for sickle cell , scarce donors

Question 7

disseminated intravascular coagulation (DIC)

Answer 7

bleeding and thrombotic disorder, decrease in clotting factors in: CLOTTING AND BLEEDING AT THEY SAME TIME

Question 8

clinical manifestations of DIC

Answer 8

o Skin: Pallor, cyanosis, necrosis
o Respiratory: Tachypnea, orthopnea, PE, ARDS
o CV: Tachycardia, hypotension, EKG changes
o GI: Abd distention, bloody stools, ileus
o Urinary: Oliguria, renal failure
o Neuro: Vision, HA, ALOC, irritability
o MSK: Bone and joint pain

Question 9

diagnostics for DIC

Answer 9

o Full CBC (DIC PROTOCOL)
- Bleeding times all prolonged (PT,PTT,aPTT)
- Clotting is decreased (platelets and fibrinogen

Question 10

interventions for DIC

Answer 10

o Stabilize patient ABCs & Fluids
- STOP THE PROCESS
- May give blood, NS, and give clotting factor back
o Treat cause
o Specific blood and clotting factors

Question 11

normal PT

Answer 11

11-12.5 SECONDS

Question 12

normal INR

Answer 12

0.75-1.25

Question 13

normal PTT

Answer 13

60-70 SECONDS

Question 14

normal aPTT

Answer 14

30-40 SECONDS