NSG 3800 & 3850 EXAM 1
1. Sickle Cell Anemia
Answer a genetic disorder that causes abnormal hemoglobin, resulting in some red blood cells assuming an
abnormal sickle shape
2. What does sickle cell anemia cause?
Answer Abnormal shape of RBCs can cause decreased oxygenation (because of the shape they can carry
oxygen as eflciently).
They can also cause occlusions in blood vessels, resulting in pain.
3. What are the expected lab values for sickle cell anemia?
Answer Hemoglobin and Hematocrit will be chronically low, however, when dehydrated they will create a
'false' increase in values.
Bilirubin will increase.
WBC & Platelet will be higher (referred to as a chronic inflammatory state)
,4. sickle cell anemia clinical manifestations & expected findings?
Answer Joint Pain Fatigue
Tachycardia/Murmurs/Cardiomegaly (big heart)
Jaundice (Due to excess bilirubin)
Low O2 Saturation
HEADACHE THAT WON'T SUBSIDE
5. Why does sickle cell anemia cause higher levels of bilirubin?
Answer Sickle cell patient's RBCs do not have as long as a life span as normal RBCs, therefore they are dying
out faster than the liver can filter them out.
6. sickle cell crisis
Answer Acute Vaso-Occlusive Crisis
Entrapment of erythrocytes & leukocytes leading to tissue hypoxia, inflammation, and necrosis. It is VERY
painful.
7. Sickle cell crisis
Answer Acute Chest Syndrome
,This is the leading cause of death in patients with sickle cell.
a severe lung-related complication of sickle cell disease that attects both children and adults. It creates a pneumonia
like illness.
8. Sickle cell crisis
Answer Aplastic Crisis
Results from the human parvovirus.
Hemoglobin levels will fall rapidly and bone marrow cannot compensate, AS EVIDENCE BY THE ABSENCE OF RETICU-
LOCYTES (immature RBCs)
9. Sickle cell crisis
Answer Sequestration Crisis
Results when organs pool the sickled cells. Can ettect the liver, spleen, and LUNGS.
, 10. Complications of Sickle cell disease?
Answer Stroke, Kidney/liver Failure, HF, Pulmonary HTN, Acute Chest Syndrome, Infection, & Reproductive
Issues.
remember these patients are at risk for occlusions in blood vessels.
11. Sickle Cell Nursing Interventions
Answer H.ydration O.xygenation
P.ain Management
Keep the patient warm. Cold temperatures can send these patients into a crisis.
YOU NEED AN ORDER TO GIVE PRN BREAKTHROUGH PAIN MEDICATIONS.
12. Sickle Cell Nursing Care
Answer educate on PCA pump, incentive spirometry. Cluster care as much
as possible.
Allow patients to take breaks during activities.
Infection prevention
1. Sickle Cell Anemia
Answer a genetic disorder that causes abnormal hemoglobin, resulting in some red blood cells assuming an
abnormal sickle shape
2. What does sickle cell anemia cause?
Answer Abnormal shape of RBCs can cause decreased oxygenation (because of the shape they can carry
oxygen as eflciently).
They can also cause occlusions in blood vessels, resulting in pain.
3. What are the expected lab values for sickle cell anemia?
Answer Hemoglobin and Hematocrit will be chronically low, however, when dehydrated they will create a
'false' increase in values.
Bilirubin will increase.
WBC & Platelet will be higher (referred to as a chronic inflammatory state)
,4. sickle cell anemia clinical manifestations & expected findings?
Answer Joint Pain Fatigue
Tachycardia/Murmurs/Cardiomegaly (big heart)
Jaundice (Due to excess bilirubin)
Low O2 Saturation
HEADACHE THAT WON'T SUBSIDE
5. Why does sickle cell anemia cause higher levels of bilirubin?
Answer Sickle cell patient's RBCs do not have as long as a life span as normal RBCs, therefore they are dying
out faster than the liver can filter them out.
6. sickle cell crisis
Answer Acute Vaso-Occlusive Crisis
Entrapment of erythrocytes & leukocytes leading to tissue hypoxia, inflammation, and necrosis. It is VERY
painful.
7. Sickle cell crisis
Answer Acute Chest Syndrome
,This is the leading cause of death in patients with sickle cell.
a severe lung-related complication of sickle cell disease that attects both children and adults. It creates a pneumonia
like illness.
8. Sickle cell crisis
Answer Aplastic Crisis
Results from the human parvovirus.
Hemoglobin levels will fall rapidly and bone marrow cannot compensate, AS EVIDENCE BY THE ABSENCE OF RETICU-
LOCYTES (immature RBCs)
9. Sickle cell crisis
Answer Sequestration Crisis
Results when organs pool the sickled cells. Can ettect the liver, spleen, and LUNGS.
, 10. Complications of Sickle cell disease?
Answer Stroke, Kidney/liver Failure, HF, Pulmonary HTN, Acute Chest Syndrome, Infection, & Reproductive
Issues.
remember these patients are at risk for occlusions in blood vessels.
11. Sickle Cell Nursing Interventions
Answer H.ydration O.xygenation
P.ain Management
Keep the patient warm. Cold temperatures can send these patients into a crisis.
YOU NEED AN ORDER TO GIVE PRN BREAKTHROUGH PAIN MEDICATIONS.
12. Sickle Cell Nursing Care
Answer educate on PCA pump, incentive spirometry. Cluster care as much
as possible.
Allow patients to take breaks during activities.
Infection prevention
