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Sickle cell by Janel Cruz (nursing diagnosis (risk for impaired gas…
Sickle cell by Janel Cruz
Onset
birth
pathophysiology
This is an inherited disease process which will then cause a mutation of the hemoglobin cell. Rather than a normal hemoglobin the hemoglobin that will be produced will be half moon shaped. This hemoglobin is called HbS. The shape makes it so that the rbc cant carry as much oxygen and the shape will also make it susceptible to catching in the intersections of the circulatory system.
diagnosis
genetic screening, cbc count, hemoglobin solubility test, blood cutures, ABG, chest x-ray, CT scan, MRI, ultrasonography
treatment:
there is no cure, lifetime management.
educate the parents on how to assess for sickle cell crisis.
infection is a big issue so any signs of infection such as a fever must be reported. Vaccination: pneumococcal vaccine and penicillin prophylaxis
episodes of pain must be managed through NSAIDS or opioids if called for
risk factor = family history
nursing diagnosis
risk for impaired gas exchange related to decreased oxygen carrying capacity of RBC.
monitor repiratory rate, depth and use of repiratory muscles
auscultate and note breath sounds
assist patient in coughing and deep breathing exercise
give patient plenty of rest periods in between treatment
encourage adequate fluid intake
administer oxygen as needed
administer packed RBCs as needed
risk for ineffective tissue perfusion
monitor repiratory rate, depth and use of repiratory muscles
auscultate and note breath sounds
administer antisickling medication as ordered
Maintain adequate fluid intake and monitor urine output.
Assess skin for pallor, cyanosis, coolness, diaphoresis, and delayed capillary refill.
Risk for acute pain related to occlusion
assess for pain
encourage ROM facility
plan activities when anaelgesics are effective
apply warm moist compress to affected joints and other painful areas
administer pain medication as ordered
administer oxygen as needed