NR 507 Week 3: Discussion Part One

A 17-year-old African American female from the inner city complains of severe chest and abdominal pain. Upon examination, the attending physician performs an EKG, chest x-ray, and an abdominal and chest clinical examination and finds nothing. Assuming she is drug seeking, he sends her home. She comes back to the ER 4 hours later and now you see the patient. She explains that she was running track this past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts feeling extensive pain in her chest and abdomen. She has jaundiced eyes, her blood pressure is 98/50, pulse is 112, T = 99.9 F, R = 28. The pain seems out of proportion to the physical findings. During a review of her medical history, she tells the provider that she has history of sickle cell anemia. At this time, it is determined that she is in a sickle cell crisis.

1. What is the etiology of sickle cell anemia?

2. Describe in detail the pathophysiological process of sickle cell anemia.

3. Identify hallmark signs identified from the physical exam and symptoms.

4. Describe the pathophysiology of complications of sickle cell anemia.

5. What teaching related to her diagnosis would you provide?

In addition to the textbook, utilize at least one peer-reviewed, evidence based resource to develop your post.

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A 17-year-old African American female from the inner city complains of severe chest and abdominal pain

1. What is the etiology of sickle cell anemia?

Sickle cell disease is “a group of disorders characterized by the presence of an abnormal form of hemoglobin—hemoglobin S (HbS)—within the erythrocytes” (McCance, Huether, Brashers, & Rote, 2013, p. 1063). It is an inherited disease from at least one of the parents. Sickle cell disease is a lifelong illness, but it can be managed. There are different types of sickle cell disease including sickle cell anemia, sickle cell-thalassemia disease, and sick cell-HbC disease. There is even the sickle cell trait where a person can be a carrier, having inherited the HB S from one parent. However, there are rarely clinical issue with those who are just carriers. Sickle cell anemia is a normocytic-normochormic anemia, or NNA, meaning that it is “characterized by erythrocytes that are relatively normal in size and hemoglobin content but insuffcient in number” (McCance, Huether, Brashers, & Rote, 2013, p. 993). There are five groups of NNAs including the hereditary hemolytic type that sickle cell anemia is because of the destruction by eryptosis, or the destruction erythrocytes through cell shrinkage, membrane blebbing, or activation of proteas (McCance, Huether, Brashers, & Rote, 2013, p. 993). Sickle cell anemia is the most common sickle cell disease and the most severe (NHBLI, 2014). It is estimated that there are between 70,000 and 100,000 Americans who suffer from sickle cell anemia with those affected most being of African ancestry. While sickle cell has a high rate of morbidity, more than 90% of diagnosed children do survive into adulthood, however, their lifespan is diminished (NHBLI, 2014). Sickle cell disease is screened in every newborn born in a hospital in the United States. This is done through a simple blood test that checks the hemoglobin in the body.

A 17-year-old African American female from the inner city complains of severe chest and abdominal pain

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