Medical Case Study: M. H. Sickle Cell Disease

Sickle cell anemia is an anemia that is inherited and mostly affects people whose heritage can be traced back to places where malaria was prevalent. There are approximately 100,000 Americans that have the disease and many more with the trait. Several of my family members are afflicted by this medical condition that causes red blood cells to take on an irregular shape.

.What does the map of the prevalence of hemoglobin disorders worldwide indicate about the disease?

CVA related to Sickle Anemia (SCA) with crisis is the primary admitting diagnosis for a 45 year old Hispanic client with a history of DM type 2, HTN, CHF and sickle cell anemia who came to the emergency room after waking up to left sided weakness, blurry vision, and occipital headache, with SOB and chest pain upon waking at 0430 am. SCA is a genetic disorder that causes a malformation of the hemoglobin cells that are attached to the red blood cells causing a decrease in the cell oxygen carrying capacity. Hemoglobin in itself is a protein that binds iron and oxygen to the cells and because the shape of the SCA cells are deformed; the surface area for bonding is decreased therefore the name sickle cell is characteristic of its formed shape.

Initial assessment of my patient revealed she had an increased work of breathing using accessory muscles she had a fever of 39 degrees Celsius. Vital signs included, respiratory rate 31, blood pressure 130/85, breath sounds were diminished with crackles in the bronchioles. Chest physical examined revealed increased fremitus and a dull percussion note.

People who have SCD do not have much access to comprehensive care unlike people with other genetic disorders such as hemophilia and cystic fibrosis. Sickle cells can also block the flowing of blood through the vessels. This results in lung tissue damage (a acute chest syndrome), pain episodes ( in the arms, legs, chest, and abdomen), stroke and priapism (a painful prolonged erection). This may also cause damage to most organs in the body. Such as the spleen, kidneys, and liver. When the spleen is damaged, patients especially children can be overcome by bacterial infections.

A 25-year-old women with homozygous sickle cell disease presented to tertiary center at 32 weeks’ gestation with weakness, fever, and worsening anemia. Her obstetric history included previous pregnancy post two years complicated with mild preeclampsia resulting in cesarean delivery at term, but had no reports of sickle cell complications like painful crisis, splenic sequestration or blood transfusion. On arrival she reported left upper abdominal pain, temperature 38oC, heart rate 115bpm, blood pressure of 120/80. Her spleen was palpable 4cm below left costal margin with tenderness. Laboratory results indicated hemoglobin 2.4g/dl and hematocrit 7.8%.

The sickle-shaped red cells interfere with normal blood flow by plugging up small blood vessels. Sickle-cell anemia occurs when an individual inherits a sickle-cell gene from each parent. Programs have been initiated to detect carriers, who do not themselves show the trait; such carriers are informed that a child resulting from the union of two carriers runs a one in four risk of having sickle-cell disease. Therapy for sickle-cell anemia is largely symptomatic. Preventive administration of penicillin to affected children by the age of four months greatly decreases mortality from infections.

Sickle Cell Disease is predominantly among people from African, Asian, Arabian and Mediterranean countries. Nonetheless, due to population migration, it is a global health problem with psychosocial implications. SCD afflicts up to 100 million people worldwide and more tormenting, the life expectancy of patients with SCD is quite variable. Some die at an early age while others have virtually unrecognized conditions and can live active lives, but few lives till advanced age. Patients who are older than 30 years of age are called long-term survivors (Sickle cell disease, 2012, p.4). Finding indicates that most patients with SCD sufferers, regardless, of their social circumstances, do worry about the psychological and social effects of their illness.

In this article, it talks about cholera outbreaks in Vietnam again. Cholera is contagious that causes diarrhea. It often happens in poor and high populated counties that have a difficult time getting safe to drink water such as Vietnam. From 1979 to 1996, there was high amount of people in Vietnam with cholera. In 1997 there was vaccination for it so the amount decreased, however in 2006 the amount of people affected increased again. The cause was linked to food and unsanitized water from the river- the main source of water. They collected water samples from patient’s houses, indoor water, wastewater, fresh water, and drinking water. Patients who reported that they had acute diarrhea would be sent to a cholera center to make sure they do spread

Anemia: According to National Heart, Lung and Blood institute, anemia is the most common blood disorder in the United States affecting over 3 million individuals (2015). It develops when the blood lacks oxygen. It is a condition whereby ineffective DNA synthesis occurs as a lack of hemoglobin nutrients. Clinical manifestations develops as a response in the body due to tissue hypoxia and are manifested as dyspnea on exertion, fatigue- as a result of the heavy workload of the organs in the system not functioning properly; dyspepsia with nausea, shortness of breath, dizziness, pale skin, cold hands or feet’s, chest pain and headaches, depending on the severity of the disease and comorbidity. There are different types of anemia: sickle cell anemia,

Sickle cell is a disease that affects many people all over the world. This paper will share the effects, symptoms, and cures. These red blood cells can cause abnormal break down, delayed development, and also shortness of breath.

Sickle cell anemia is a genetically transmitted disorder marked by episodes of painful crisis, severe hemolytic anemia, and increased susceptibility to infections. This disorder usually affects African American (Zelman, Tompary, Raymond, Holdaway, & Mulvihill, 2010) Since this disorder is inherited and affects African-American this puts Davon at a higher risk. Sickle cell anemia can be diagnosed by having a genetic testing and blood test. Some symptoms of this disorder are pain crisis, fatigue, splenic sequestration, bacterial infections, shortness of breath, and eye damages. Some treatments for sickle cell anemia are supportive therapy during the crisis, blood transfusions, and prevention of sickle cell crisis. Since this is an inherited disorder, there is no prevention. This blood disorder is usually diagnosed in childhood and persists throughout a person’s life ("Mayo Clinic", 2015).

1. List your publications/presentations, if applicable. Include authorship rank, submitted/published/ presented, when/where, work in progress.

My daughter has sickle cell anemia. The doctor's specified to me what it was and said sickle cell anemia is a blood disorder that lacks red blood cells. As a seven year old Ophelia doesn’t really get affected by the news as a parent does. Ophelia has told me she has been feeling weak and said her feet and hands were swelling. I checked and I immediately called the doctor and he said she’s been experiencing an early stage of an organ failure. I was terrified by the news. It seems like life is getting harder and harder not only for her, but for me as a parent who wants the best for their child. I scheduled an appointment for a chronic transfusion therapy, that helps vital organ failure. Later within a month my daughter got treated with chronic

As an advanced practice nurse (APN), one will care for many patients with hematological disorders. Over the years the prognosis for these individuals has drastically improved. The purpose of this paper is to describe sickle cell anemia (SCA), evaluate the treatments, and discuss how age affects all of these things.