Week 9-sickle Cell Flashcards
Patho
Hemoglobin a replaced with hemoglobin s
If both parents have trait 1/4 chance child gets disease
Signs and synptoms
Labs-S shaped hemoglobin
Swelling
Fever
Pain
Nursing assessments
Pain assessment
Sickle cell crisis assessment
Cardio and neuro assessment
This that can trigger blood loss
Menses, potential GI lose
Can worsen sickle cell symptoms
Manifestations of sickle cell
Vassooclusive crisis
Acute chest syndrome
Sequestration crisis
Cerebrovascular accident
Emotional and behavioral problems linked to long hospitalization
When does child start showing sickle cell symptoms
4-6 months
Fetal hemoglobin resists sickling and suppress symptoms
Sickle cell crisis
Acute exacerbation that varies in frequency and severity
Types of sickle cell crisis
Vaso-occlusive thrombotic
Splenic sequestration
VOC
Most common-very painful
Stasis of blood with clumping of cells in microcirculation ->ischemia->infarction
Signs if VOC
Fever
Pain
Tissue engorgement
Splenic Sequestration
Life threat-death in hours
Blood pools in spleen
Signs of splenic sequestration
Profound Anemia, hypovolemia, shock
Do sickle cell patients get chronic skin ulcers
Yes
Testing for sickle cell
Hemoglobin electrophoresis-quantifies percent of types of HGB S and HGB A
Sickledex-used with fingerstick blood gets results in 3 mins to determine presence of HGB S
Complications of sickle cell
Hypoxia
Ischemia
Infection
CVA
Anemia
Renal failure
Heart failure
Nursing interventions
Pain management
Fatigue management
Infection prevention
Pain meds
Hydration(Iv or oral fluids)
Antibiotics
02 if sat less than or equal to 92
Monitor child’s growth for failure to thrive
Multisystem assessment
Assess pain
Observe for inflammation or infection
Monitor for shock
Polycythemia
Increased RBC volume
Secondary polyc.
-too much erythropoietin bc of lower oxygen, cyanotic heart disease, nonpatholical conditions or Neoplasms
Medical management
Not needed if condition is mild
Treat underlying cause
Therapeutic phlebotomist
Prophylactic antibiotics
Monitor reticulocyte count to evaluate bone marrow function
Blood transfusion can be given early in crisis to reduce ischemia
What does frequent transfusions cause
Hemosiderisis- iron in tissue
Treat with iron chelation(feroxanine) and vitamin C for iron excretion
