Case Study: Sickle Cell Anemia

Sickle Cell Anemia is a very serious disorder and people suffer from it every day. It is a genetic disorder that causes the hemoglobin in the red blood cell to distort and form into a sickle like shape. The name comes from the shape of the blood cell after it is mutated. A person who has sickle cell anemia got it from inheriting from the parents. It is the most common inherited disorder in the United States. It is also has four other names this disorder can go by HbS, Hemoglobin S Disease, SCD, and Sickle Cell .(https://ghr.nlm.nih.gov)the blood cell is formed wrong turning it into a sickle or crescent shape. Sickle cell is only a disorder. It can also be treated a lot of different ways.

For clinical week 9, I was assigned to the UMC Wound Care Clinic to view a different field of nursing. As soon as I arrived at the clinic the nurse told me that I could bounce around from patient room to patient room to view as many wounds and burns as possible. The first patient room that I went into was a young Hispanic man who had an infection on his right lateral thigh area that spread from the popliteal area to the greater trochanter. When I asked the patient what had happened he told me he was injured at work and the injury got infected, which he never went to the doctor to have it evaluated. So, basically the infection was eating away at his skin and muscles. The patient has to come to the wound clinic every day to get dressing changes.

“It isn’t fair. I’ve worked so hard all my life, I don’t deserve this,” thought Mrs. Ross as she looked down at her right leg where a large wound gaped open. Two weeks ago, she had a femoral-popliteal bypass, which got infected. The wound was opened up and was healing slowly by secondary intention. It was painful, raw, and frightening. She put a hand on her chest and raised the head of the bed higher so she could catch her breath and stare out the window.

I am a second year nursing student in my third week of the practicum placement on a surgical ward with my co-student and the morning shift registered nurses. We had just finished analysing the patients handover report (Levett-Jones & Bourgeois, 2015) and I had been assigned to work with the registered nurse. I was looking after Mrs. Brown (pseudonym) is 82 years old New Zealander was admitted to surgical ward on the 08/06/16 for multiple SCC removals from L) hand and L) foot with skin grafts.

“Someone call 911”, I said, when I saw a girl fall down the stairs lying unconscious. The nurse at Rockdale County High School assisted with the situation. My friend Fred and I held her so she wouldn’t hurt herself any more than had already been done. The nurse notified us that this girl has epilepsy (meaning that a person has had two or more seizures, but it’s not contagious & is not caused by mental illness or mental retardation). I didn’t pay too much attention to what the nurse was saying because I was focused on the girl's breathing and her ability regain consciousness. The nurse insisted on calling her sister to be there for her when she wakes up. The nurse knew that when she would wake up, she would want to hug one of us or her sister because all she remembers is blacking out during the time it took place.

As I walked toward the bright red sign that flashed emergency, I had no idea that I was about to witness the fragility of life. About a half an hour after my clinical shift began the rapid response alarm blared through the emergency room speakers. I was excited. In my previous shifts I had worked with the rapid response team. During rapid responses more extensive medical procedures are performed, and as a student I got to see and do a lot more. Once I reached the recess room, most of the team was already there preparing for the arrival of the patient. “It’s a STEMI” announced one of the nurses who was on the phone with firefighter’s that were bringing him in. After she announced this fright ran through my veins. I had never seen someone who

My second patient of the day was D.B.. He was a four year old male admitted to the hospital for pneumonia, bronchiolitis, and respiratory syncytial virus (RSV). On top of being admitted to the hospital for these issues, D.B. also suffered from cerebral palsy and had a thorough medical and surgical history. D.B. was a premature fetus at 34 weeks. When I first walked into the room, I thought that I was in the wrong room or had the wrong patient in the crib since D.B. was said to be four years old but looked like he was about two years old.

During her career as a pediatric nurse, she became very connected with a patient who happened to be her first death encounter. At the time, the patient was a six-year-old boy who was diagnosed with leukemia. ML said: "When I was caring for this patient, I was a mother myself. Seeing that boy and his family suffer gave me so much heartache… it was hard not to make it personal." The more she worked with this child, she observed the pain and suffering him and his family had to go through. She also learned about him and the family dynamics which enabled ML to help the patient and the family become well involved in understanding one another and guide care towards an agreement that everyone was satisfied with. As I reached for the tissue box to hand it to her, I rephrased the story to confirm the understanding of the story. She nodded and continued on talking about things she has done for the patient. Being a mother and a nurse, she believed in providing this child with what a healthy boy would be doing at his age. ML's strategies involved promoting short physical activities, playing games, and encouraging the parents to participate in such activities if possible; ML wanted to provide a lighter atmosphere around the unit and help the patient disregard the diagnosis even if it was just for a little while. Over the past few months, she continued to assist this patient as his

The objective of this reflection is to explore and reflect upon a situation from a clinical placement on an orthopedic unit. The incident showed that I did not provide safe, timely and competent care for my patient when the oxygen saturation was low. Furthermore, this reflection will include a description of the incident, and I will conclude with explaining what I have learned from the experience and how it will change my future actions.

It was reported that Sammy is the only person in the family to have been diagnosed with SCD. While it is not stated here, even though no other family member has presented with SCD, it can be assumed that both of Sammy’s parents have the sickle cell gene. As stated before, two parents with the sickle cell gene have a 25% chance of having a child with SCD. Sammy’s presentation is that of a six-year-old boy weighing only 64 pounds, despite the fact that he is 14-years-old. His size is directly related to his frequent episodes of sickle cell crisis. During a sickle cell crisis, the body’s ability to provide the tissue with proper oxygen and nutrients is impaired.

Nurses have a duty to each patient to be alert to any changes in their conditions, perform accurate clinical assessments and respond expediently (Scott, Rogers, Hwang, & Zhang, 2006). Each nurse present (Jeffery, RN, Diana, RN and Carol, LPN) was responsible for these actions for each patient, regardless if they were assigned to them or not. This duty was breached when Ms. Pinellas’ IV was ignored for 45 minutes. Ms. Pinnelas stated a nurse “came in and pressed some buttons and the pump stopped beeping”. The nurse failed to assess Ms. Pinnela’s hand or check if infusion was complete. This is another form of a breach of duty. Damages caused by this infiltrated IV are necrosis of the hand, requiring multiple surgery procedures, including skin grafting and reconstruction. Further damages include loss of function and deformity to some

The patient was a female and is classified in the 75-80 age range. She was admitted to the hospital due to a fall, resulting in a spinal cord injury in the cervical and thoracic regions. The patient was taken to a Medical-Surgical Unit and was then transferred to a Rehabilitation Unit, where she is able to heal and efficiently practice ADL’s around his or her spinal cord injury. As a nursing student, my role was to provide my patient with education concerning her diagnosis and safety precautions that apply. The patient was taught about fall preventions, pressure ulcers and aspirating as well as learning about the function and importance of her spinal cord. Fall prevention was a topic that was very important to the patient due to falls on previous occurrences. I had talked to my patient about pressure ulcers because she has decreased mobility due to her spinal cord

During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to

Madsen et al. developed this classification to asthmatic, cardiac, lymphatic, and sickle cell-related disease states(10, 13, 14). Madsen et al.(10, 13) defined this classification depending on the analysis of prior case studies. Cardiac patients mentioned by them consist of eight Fontan patients, one Glenn shunt patient and three Blalock–Taussig shunt patients. The casts can be immediately expectorated and sometimes patients will cough up large amount from their tracheobronchial tree(14). If the patients do not expectorate, it may delay the diagnosis(14). Patients often need bronchoscopy for the expulsion of cast(14). It is a rare condition that is mentioned in asthma and sickle cell disease patients and has higher mortality in patients with congenital heart disease(10, 13) and death is not unusual due to the occlusion of airway from a cast(14). The pathophysiology and management of plastic bronchitis is not clear due to insufficient clinical data. Over the years, plastic bronchitis has been labeled by various names as Hoffman's bronchitis, cast bronchitis, fibrinous

I believe that you have come across this health condition -sickle cell disease (SCD). It's a serious type of blood disorder commonly known as sickle cell anemia. At first I thought it a rare condition but nowadays there are an increasingly high number of people suffering from the same. Sickle cell anemia is a hereditary condition in which the patient's body does not have enough healthy blood cells to carry oxygen around the body. The red blood cells assume an irregular shape of that resembles a sickle or the crescent moon. This makes the sickled cells to get stuck in the blood vessels causing blockage of the flow of blood and oxygen. This condition is mostly diagnosed during infancy that is around 5-6 months though it may arise at as later