Sickle Cell Disease Case Study

PHYSICAL EXAMINATION: Vital Signs. TEMPERATURE: 101.0, Blood Pressure- 127/179, Heart Rate-129, Respirations- 185, Weight-215. Situations 96% on room air. Pain Scale- 8/10. HEENT-Normal cephalic, atrumatic pupils equally round and reactive to light. Extra ocular motions intact. ORAL: Shows oral pharynx clear but slightly dry mucosal membranes. TMS: Clear. NECK: Supple, No thrangegally or JVD. No cervical, subclavicular, axilarry or lingual lymphinalpathy.

The presence of fluid in the alveolar space could potentially cause the lung capacity to be effected as well.

As Jane was presenting with a symptom of a life threatening event it was important that treatment was immediate. Priority was initially made from assessment of the airways, breathing and circulation, level of consciousness and pain. Jane’s respirations on admission were recorded at a rate of 28 breaths per minute, she looked cyanosed. Jane’s other clinical observations recorded a heart rate of 105 beats per minute (sinus tachycardia), blood pressure (BP) of 140/85 and oxygen saturation (SPO2) on room air 87%. It is important to establish a base line so that the nurse is altered to sudden deterioration in the patient’s clinical condition. Jane’s PEWS score (Physiological Early Warning Score) was 4 and indicated a need for urgent medical attention (BTS 2006). Breathing was the most obvious issue and was the immediate priority.

of 116 bpm, respiratory rate of 18 breaths/min, and blood pressure of 86/54 mm Hg. The

Sickle cell anemia is a hereditary disorder that mostly affects people of African ancestry, but also occurs in other ethnic groups, including people who are of Mediterranean and Middle Eastern descent. More than 70,000 Americans have sickle cell anemia. And about 2 million Americans - and one in 12 African Americans - have sickle cell trait (this means they carry one gene for the disease, but do not have the disease itself).

PHYSICAL EXAM: Temperature 98.6, Blood pressure 140/90. Pulse 110. Respirations 26. Her lungs are clear, showing mild signs of distress. Heart sounds are normal, irregular rhythm and bradycardia noted. No edema noted in extremities. Patient skin is cool to touch, slightly clammy. EEG shows prolonged QRS wave, with ischemic ST changes and PVCs. Chest radiograph clear.

Lungs: Diminished breath sounds in all lung fields. Resonant to percussion. No wheezes, rales, or rhonchi. Symmetric chest expansion. Breathing nonlabored.

pulse is 110. At this time, her respirations are 26, her SaO2 is 97%, and her

1000 Pt denied pain at this time and rate 0 on a scale of 0 to 10. Pt thanks me a lot for pain medication I gave her. Instruct the pt to report her pain early before it get worse so I can give pain medication. Pt verbalized understanding of the teaching. No sign of distress or discomfort at this time. Will continue to monitor………L.Gotora

Lungs: Diminished breath sounds in all lung fields. Resonant to percussion. No wheezes, rales, or rhonchi. Symmetric chest expansion. Breathing nonlabored.

The Sickle Cell gene needs to be inhered from both of the parents; otherwise the individual will only carry the Sickle Cell trait. If the sickle cell trait is carried by an individual they can be asymptomatic. This individual can, however, transfer the gene abnormality to any offspring that they have. Sickle Cell Anemia is the most common form of sickle cell disease. It is also the most severe form of the disease. One variation of sickle cell anemia is hemoglobin SC disease and is one of the more common variations. Many times it manifests with a lesser degree of hemolytic anemia (1).

Sickle cell disease is categorized as an autosomal recessive disease. That means in order for one to inherit the disease, they must inherit two recessive alleles for sickle cell disease, or hemoglobin S gene. Having only one recessive allele makes you a carrier. The disorder causes the affected person’s red blood cells to disfigure into a crescent or sickle, which differs from the normal red blood cells that shaped into a doughnut. Sometimes, cells in a sickle shape cannot get through the narrow passageways of the blood vessels as easily as normal red blood cells. This blocks blood from entering and oxygen can’t reach the affected person’s organs. It can also crystallize and block arteries and

This disease is a genetic disease and it is hereditary. It is inherited as an autosomal recessive disease. This means that in order to get the gene you must receive a recessive trait from your mother and your father. The parents could both be heterozygous for the trait and therefore not have the disease, but instead they would both be a carrier. There are only a few ways that the parents could possibly pass the trait. One possibility of having a child with sickle-cell disease is if both parents are heterozygous and they both pass on their recessive allele, (25% chance for offspring to have sickle-cell disease). Another possibility

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.

Respiratory: Lung sounds are clear on auscultation without rales, rhonchi, or wheezes. Respiration unlabored with