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Sickle Cell Anemia FUNDAMENTAL Reasoning(Anthony Perkins, 15 years old) 2021 latest edition $12.49   Add to cart
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Sickle Cell Anemia FUNDAMENTAL Reasoning(Anthony Perkins, 15 years old) 2021 latest edition
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History of Present Problem: Sickle Cell Crisis Anthony Perkins is a 15-year-old African American male who was at a medically monitored summer camp and participated in several sports activities when the outside temperature was greater than 90 degrees. He began having pain in his knees and ...

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  • October 6, 2021
  • 11
  • 2021/2022
  • Exam (elaborations)
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  • sickle cell anemia fundamental reasoning

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  • Nur 1211
  • Nur 1211

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Sickle Cell Anemia
FUNDAMENTAL Reasoning
Anthony Perkins, 15 years old
Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
1.Pain
2.Clotting© 2021 Keith Rischer/www.KeithRN.com
FUNDAMENTAL Reasoning: STUDENT
History of Present Problem:Sickle Cell Crisis
Anthony Perkins is a 15-year-old African American male who was at a medically monitored summer camp and participated in several sports activities when the outside temperature was greater than 90 degrees. He began having pain in
his knees and was evaluated by the camp nurse. After evaluation, he was transported to his primary care provider and evaluated. Anthony was transferred as a direct admit to the pediatric floor of the community hospital where you are the primary nurse responsible for his care. He weighs 154 lbs or 70 kg.
Personal/Social History:
Anthony was diagnosed with sickle cell anemia at birth during a routine newborn screening. He was a newborn with
normal childhood illnesses. He has been hospitalized with pneumonia four times – at age 8, 9, 11, and 14. He is up to date
on childhood immunizations, and recently received his pneumococcal and influenza vaccines.
Anthony has had multiple hospitalizations for sickle cell crises and transfusions. He lives with his parents and two
siblings, a younger brother (9 years old), and sister (4 years old). His family lives in a three-bedroom, two-bath home.
Anthony’s father is an accountant and the sole financial provider of the family. Anthony’s mom stays home, raising
the children. The family is covered by a private medical insurance PPO through Anthony’s father’s employer.
What data from the histories are important and RELEVANT and have clinical significance for the nurse?
RELEVANT Data from Present
Problem:Clinical Significance:
15 years old, Male
African American
Outdoor Sports in >90degrees
Pain in bilateral knees
Current Weight- 154lbs / 70kgThis patient's age establishes how long he has had this disease since he was born with it and Sickle cell is more common among African Americans. Sickle cell patients tend to be very sensitive to temperatures and that alone can cause a crisis and if you add playing sports to the mix this can worsen symptoms. Any pain can be a sign of a pain crisis and may signify that there is a possible blockage of blood flow. Current Weight is necessary for any further pharmacological or transfusion measures to be taken. (Hinkle 2018)
RELEVANT Data from Social History:Clinical Significance:
Sickle cell present at birth
Term newborn
Hospitalized with Pneumonia x4; ages 8,9,11 & 14
Up to date on immunizations and recently
Pnuemococcal & Flu vaccines
Multiple hospitalizations for sickle cell and
transfusionsThis is an ongoing disease process that has started at birth and this places the patients at greater risk for acute pulmonary infections; which, this patient has experienced most recently being last year. Immunizations and vaccines are an important part of care for patients with sickle cell.
Transfusions signify that the patient has previously experienced some exacerbations of the disease process and required this specific treatment. Transfusions can help prevent strokes in patients. (Hinkle 2018)
Developing Nurse Thinking by Identifying Significance of Clinical Data The nurse recognizes the need to validate concern about fluid volume deficit, performs a set of orthostatic VS and obtains the following:
Position:HR:BP:
Lying92102/74
Standing13292/42
© 2021 Keith Rischer/www.KeithRN.com
Current VS: P-Q-R-S-T Pain Assessment (5th VS):
T: 99.4 F. (37.5 C.) (oral)Provoking/Palliative: Movement and weight bearing/Rest, elevation, warm compresses
P: 92 (regular) Quality: “My knees are really hurting…deep ache”

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