Sickle Cell Anemia NCLEX Review and Nursing Care Plans Show
Sickle cell anemia is a congenital blood disorder characterized by irregularly shaped red blood cells, commonly crescent and/or “sickles” in shape. These asymmetrical cells get stuck on small blood vessels which can slow down and even block blood flow and oxygen supply throughout the body. There is no cure for sickle cell anemia yet; however, a variety of treatments are available to control pain and to mitigate complications of the disease. Signs and Symptoms of Sickle Cell AnemiaAnemia – The normal life span of red blood cells is up to 120 days before being replaced. In the case of sickle cell anemia, the cells die within 10 to 20 days. This shortened life span, of the oxygen-carrying erythrocytes, results in decreased cell count and thus depriving the body of oxygen and causing fatigue. Pain – Patients with sickle cell anemia experience acute pain called pain crisis. This symptom is brought about by the abnormal erythrocytes blocking the blood flow of the tiny vessels on the chest, abdomen and joints, thereby causing pain. This episodic pain varies in severity and may last from a few hours to a few weeks, sometimes prompting hospital admissions for the most painful. Swelling of Hands and feet – The irregularly-shaped cells impede the natural processes of circulation by clumping on the blood vessels of the body. This blockage of blood flow thereby causes swelling of the lower extremities, particularly of the hands and feet. Infections – One of the spleen’s functions is to filter the blood of old and damaged erythrocytes. Due to the rapid deterioration of the abnormal red blood cells in Sickle cell anemia, the spleen is overwhelmed, thereby causing damage to the organ. This in turn will inhibit another function of the spleen, which is the production the infection-fighting leukocytes. Delayed Growth or Puberty – Problems in circulation cause oxygen and other nutrients to be impeded for use in the body. This in turn causes delays in growth for young children and late onset of puberty in adolescents. Vision problems – The retina is primarily responsible for the processing of images seen by the eye. But due to the clumping of the abnormal cells in the blood vessels of the retina, its functions are impeded and may cause vision problems. Causes and Risk Factors of Sickle Cell AnemiaIn sickle cell anemia, the gene responsible for the binding of hemoglobin to red blood cells is affected. This mutation causes for the red blood cells to act abnormally to the altered hemoglobin by becoming inelastic and malformed. This in turn limits the erythrocytes capacity to carry oxygen effectively all throughout the body. Considering the genetic repercussions, it takes both the mother and father to have the defective gene for Sickle cell anemia to develop. If only one parent has the malfunctioning gene, their offspring may both carry the normal and defective sickle cell hemoglobin. Meaning, the patient will be carrying the abnormal gene but may not develop Sickle cell anemia. However, he/she will still pass on the sickle cell trait to his/her children. Patients with sub-Saharan African family backgrounds are more susceptible in developing the sickle cell trait. Other ethnicities at risk for sickle cell disease are descendants coming from South America, Cuba, Central America, Saudi Arabia, India, Turkey, Greece, and Italy. Complications of Sickle Cell AnemiaThe following are the complications of sickle cell anemia but are not limited to:
Diagnosis of Sickle Cell Anemia
Treatment for Sickle Cell AnemiaThe treatment of sickle cell anemia involves control of the signs and symptoms of the condition. Medications: a variety of medications are utilized and they are:
Sickle Cell Anemia Nursing Care PlansNursing Care Plan 1Nursing Diagnosis: Impaired Gas Exchange related to decreased oxygen-carrying capacity of the blood and abnormal RBC structure life span secondary to sickle cell anemia, as evidenced by shortness of breath, oxygen saturation of 82%, mild confusion(GCS 14), use of accessory muscles, cyanosis of the lips, heart rate of 122 bpm, restlessness, and reduced activity tolerance Please enable JavaScript Nursing Stat FactsDesired Outcome: The patient will demonstrate adequate oxygenation as evidenced by normal heart rate, easy of breathing, GCS 15, absence of restlessness, and oxygen saturation within the target range set by the physician.
Nursing Care Plan 2Nursing Diagnosis: Risk for Deficient Fluid Volume Deficit Desired Outcome: The patient will be able to maintain fluid balance in terms of input and output.
Nursing Care Plan 3Ineffective Tissue Perfusion Nursing Diagnosis: Ineffective Tissue Perfusion related to infarct, fibrosis, and iron deposits due to myocardial damage secondary to sickle cell anemia, as evidenced by abnormal vital signs, resulting in palpitations, delayed capillary refill time and absence of peripheral pulses upon palpation, disorientation to time, place and situation resulting to restlessness and confusion and will show visible skin discoloration, edema, and unhealing wound. Desired Outcome: The patient will show improvement in tissue perfusion resulting in stable vital signs, capillary refill time that is less than 2 seconds, palpable peripheral pulses, calm pace and properly oriented, normal pinkish color of nail beds and will demonstrate desirable fluid intake and urine output.
Nursing Care Plan 4Acute Pain Nursing Diagnosis: Acute Pain related to the blockage of sickled cells into small blood vessels which transport blood and oxygen as evidenced by localized bone and joint pains as evidenced by a decrease in range of motion and immobility, recurrent abdominal pain, low back pain, and transient headache. Desired Outcome: The patient will demonstrate knowledge in alleviating pain with effective pain relief measures and exercises that minimize the use of pain relief medications, will frequently perform routine range of motion exercises and be able to move freely, will have adequate rest, and relaxation and will verbalize relief from pain.
Nursing Care Plan 5Impaired Skin Integrity Nursing Diagnosis: Impaired Skin Integrity related to vaso-occlusion and venous stasis secondary to sickle cell anemia, as evidenced by the loss of sensation and decreased physical movement as evidenced by presence of a non-healing stage 2 pressure ulcer. Desired Outcome: The patient’s pressure ulcer will have optimal healing and will be able to prevent further dermal ischemic injury and the patient will demonstrate knowledge in performing measures on how to reduce skin breakdown such as proper turning, use of protectors, and early detection.
More Sickle Cell Anemia Nursing DiagnosisNursing ReferencesAckley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon Disclaimer:Please follow your facilities guidelines and policies and procedures. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. |