brittany long v sim care plan nursing care of the childbearing family raritan valley community college
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lOMoARcPSD|8163834
Brittany Long v SIM Care Plan
Nursing Care of the Childbearing Family (Raritan Valley Community
College)
,
, lOMoARcPSD|8163834
DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE
PROCESS)
Sickle Cell Anemia: is a blood disease that affects red blood cells. Normal red blood cells are round. In
people with sickle cell anemia, hemoglobin – a substance in red blood cells – becomes defective and causes
the red blood cells to change shape. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces
normal hemoglobin which is called hemoglobin A (HgbA). Over time, the red blood cells become rigid and
shaped like crescent moons or sickles. (Clinical slides 02.02.2020)
It is an incurable disease that is often fatal by middle age because of renal failure, infection,
pulmonary failure, and/or stroke
DIAGNOSTIC TESTS (REASON ANTICIPATED PHYSICAL
FOR PATIENT INFORMATION FINDINGS
TEST AND RESULTS)
Vital signs q4h Britney long is a 5 year old African Family history of
Continuous Pulse American female with a history of sickle cell anemia or
Oximetry: Monitor O2 sickle cell disease, diagnosed at six sickle cell trait
saturation levels Labs; months old and has been prescribed reports of pain
daily complete blood count regular folic acid supplement. reports of pain.
and basic metabolic panel She was brought into the ED during shortness of breath, fatigue
the night by her mother, who stated pallor, pale mucous
Blood analysis (notable): that the patient has been membranes jaundice
Hgb 9.8 (13.5-17.5) complaining of right lower leg pain hands and feet cool to
Hct: 29 (40-45%) over the last 2 days. touch. dizziness
Reticulocytes 5.5 (0.5-1.5%) Britney rated her pain as a 5 on headac
Electrolytes the faces scale and did not want he
Creatinine: 0.4 (0.8-1.4) anyone to touch her leg during priapis
assessment. m
CBC w/ dif: SHOULD be She has not had an appetite in the hepatomeg
last 24 hours but has taken small aly
ordered to determine anemia
amounts of oral fluids. splenomeg
state & if there is a left aly
(bacterial) or right shift (viral) She has had pain crises before,
and levels of neutrophils, mostly managed at home with In a vaso-occlusive crisis
acetaminophen and ibuprofen. She / painful episode
changes in lymphocytes
monocytes increase is viral. has been hospitalized twice, once at Acute: (related to
age 4 years for vaso-occlusive crisis dehydration decreased
Neutrophils and bans are
episode and once at age 3 years for oxygen)
bacterial.
a fever. Britney was given oral pain Severe pain, usually in
medication in the emergency bones joints and
Transcranial Doppler: Department at 0600. abdomen.
Could be used to assess Swollen joints, hands
Intercranial vascular flow and She is asleep but is responsive when
awakened. She has been taking small and feet Abdominal pain
detect the risk for cerebral Hematuria
vascular accident (CVA). amounts of oral fluids and continues
to receive intravenous maintenance Obstructive
TCD is performed annually on jaundice Visual
children ages 2 to 16 years fluids at 52 milliliters per hour period
when examined this morning her disturbances
who have sickle cell disease.
blood pressure was and her
temperature was 37.4 Celsius she now
rates her pain as a three.
ANTICIPATED NURSING INTERVENTIONS
Promote rest to decrease oxygen consumption.
Administer oxygen as prescribed if hypoxia is present.
Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give
oral fluids administer IV fluids with electrolyte replacement (caution with potassium replacement)
administer blood products, usually packed RBCS an exchange transfusions per facility protocol.
Observe for manifestations of hypervolemia and transfusion reaction.
closely monitor laboratory results reporting any notable , out of range levels ,
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