NUR 211 EXAM 3
Sickle cell anemia predisposition - ANS African american
Central africa
The near east
Mediterranean
Aboriginals
Hispanics (caribbean, central and south america)
Sickle cell anemia clinical manifestations - ANS Fatigue
Weakness
Pain
Swelling
Tachycardia
Murmur
Enlargement of bones in face and skull
Sickle cell how to diagnosis - ANS CBC - low hematocrit
Hgb electrophoresis
What is sickle cell acute Vaso-occlusive crisis? - ANS Very painful, rbc and WBC entrapment
causing tissue hypoxia, inflammation, and necrosis due to inadequate blood flow
What is the sickle cell aplastic crisis? - ANS Due to parvovirus, rapid fall in HgB were bone
marrow cannot compensate
What is the sickle cell sequestration crisis? - ANS Other organs (specifically spleen) affected by
pooling of sickle cells
What triggers a sickle cell crisis? - ANS Illness
Stress
Alcohol
Dehydration
Cold weather
High altitude
Complications of sickle cell anemia - ANS Anemia, Pulmonary hypertension, Acute chest
syndrome, heart/renal failure, CVA/Stroke, infection, leg ulcers, eye damage, substance abuse
How do you treat sickle cell anemia? - ANS Management of symptoms, therapies (rx,
procedural, supportive)
, What are procedural therapies to treat sickle cell anemia? - ANS Hematopoietic stem cell
transplantation, transcranial doppler studies
What RX therapy is used to treat sickle cell anemia? - ANS Hydroxyurea
Nsaids
Morphine
Opioids
Antibiotics (pcn)
Corticosteroids
What class of drugs is hydroxyurea to treat sickle cell anemia - ANS Antineoplastic
What is the typical dose for sickle cell patients using hydroxyurea? - ANS 15-35mg/kg/day
How does hydroxyurea work for sickle cell anemia? - ANS Increases fetal hgb in children,
decreased number of circulating lymphocytes, decreases pain with crisis
What are the adverse reactions associated with hydroxyurea used for sickle cell disease? -
ANS Thrombocytopenia
Leukopenia
What are nursing roles while using hydroxyurea for sickle cell anemia? - ANS Monitor CBC,
fevers, do not crush/open, avoid handling, use caution, drink plenty of fluids, avoid pregnancy
What action does morphine have with the sickle cell anemia crisis? - ANS Drug of choice.
Relieves pain, dosing individualized, generally given IV during crisis
What side effects does morphine have while using for sickle cell anemia crisis? - ANS
Sedation, respiratory depression, constipation, urinary retention
What are the supportive therapies used for sickle cell anemia? - ANS Blood transfusions,
oxygen, hydration, rest, nutrition
What nursing management/assessment is used for sickle cell anemia? - ANS Assess prior
treatment, precipitating factors, assess all body systems (joints, pain, swelling, lung sounds, o2
says, edema, circulation, LOC, leg ulcers, skin turgor), monitor s/s infection, I&O for dehydration
What are the major goals for sickle cell anemia? - ANS Control pain, decreased episodes of
crisis, enhanced self-esteem and power, increased knowledge of disease process, absence of
complications
What are the TB risk factors? - ANS Close contact with someone who has TB,
immunocompromised, has other health problems, abuses alcohol or illegal drugs, was not
treated correctly for TB in past, no adequate HC, immigration from another country with high
