Nursing Study Guide - Sickle Cell Anemia Cheat Sheet

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Pathology Compli​cations Signs & Symptoms (cont)

Most common hemogl​obi​nop​athies Cardio​megaly, Pulmonary HTN, Restri​‐ Seques​tration crisis / Bacterial
- RBCs do not carry the normal Hgb but fxn murmur ctive lung disease Splenic seques​tration meningitis or
instead carry a less effective type Retino​pathy Cholel​ith​iasis & - Pooling of blood in liver & sepsis

Severe chronic blood disorder that occurs gallstones spleen w/ ↓ blood volume &
1/2,000 per year in U.S shock
Jaundice, Functional Asplenia
Glutamic acid is replaced w/ valine in Hgb hepato​megaly Bone
molecule → elongated RBC that is rigid & infarction
Chronic leg MODs common in
sickle w/ a shortened life spa ulcers adulthood
Nursing Interv​entions
Signif​icant anemia may occur when RBCs Stroke Sepsis
sickle Immuni​zations & ABX to Tx underlying
Delayed G&D Organs
↓ risk of infection cause (infec​‐
When cells sickle, blood becomes more & puberty
tion)
viscous b/c cells clump together & prevent
normal blood flow to the tissues of that area H-O-P to it! → Hydration, O2 during
Signs & Symptoms
since their shape cannot pass through the O2, Pain relief episodes of
Infants asympt​omatic until 3-4 months d/t
smaller capill​aries & venules → vaso-o​ccl​‐ crisis to
Hgb F protection (later half of 1st year of
usive process leads to local tissue hypoxia prevent further
life)
→ ischemia → infarction & pain crisis sickling
Pain crisis, Acute Chest Syndrome
Hemolysis occurs following sickling ↑ fluids to promote Adequate pain
recurrent pain (ACS)
hemodi​lution, 150 management
episodes - Cell clumping in lungs
Etiology / Risk Factors mL/kg/day or double helps ↓ stress;
(vaso-​occ​‐ - ↓ gas exchange →
mainte​nance w/ always believe
Inherited African (1 in 400, 8% lusive) hypoxia, wheezing,
hypotonic, D5W or D5 w/ pain level
autosomal carry trait), Medite​rra​‐ - ↑ tachyc​ardia cough, chest pain, fever
0.25% NS
recessive nean, Middle Eastern, & & tachypnea → → more sickling
pattern Indian descent NO PRN pain meds, use Assess pain w/
more sickling
fix dose, can use w/ non- the right pain
Passed on May be triggered by - Most common
ph​arm​aco​logic tool & look for
when both stress or traumatic event in joints (hot,
techniques compli​cations
parents have swollen)
of pain
gene or trait Aplastic crisis Dactylitis (hand-foot
Assess for S/S of ineffe​‐ Avoid sudden
25% risk of Hgb Infection, fever, acidosis, (profound syndrome), aseptic
ctive tissue perfusion temp change
SS, 25% Hgb dehydr​ation, physical anemia) infarction
(cooling
AA, 50% Hgb exertion, excessive cold Pale mucous Easily fatigued w/ poor
mattress for
AS exposure, hypoxia membranes appetite
fever)
Hgb AS = - ↓ BP d/t severe Acute abdominal pain
Cluster care Quiet enviro​‐
carrier & usually anemia or ↑ (most common) d/t
nment &
have only BP d/t SC sludging & spleno​megaly
privacy
minimal health nephro​pathy
problems

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 Nursing Study Guide - Sickle Cell Anemia Cheat Sheet
by helpmee via cheatography.com/148061/cs/32233/

Diagno​stics Teaching

Sickle​-Tu​rbidity Test (Sickl​edex) finger stick Family support as Promote wireless

Possib​ility or SCA or SC trait they often feel commun​ication w/ NP
guilty or respon​‐ for collab & coaching
Hgb Electr​oph​oresis
sible
Dx, only accurate test for SCA
Disease process, Regular health mainte​‐
Hgb compli​cat​ions, nance visits, immuni​‐
~6-9 mg/dL (normal 11-15 in infant) genetics, testing zat​ions, PCN, coping,
Signif​icantly lower w/ splenic seques​tra​‐ for carrier status adequate fluids
tion, ACS, or aplastic crisis Avoid temp fluctu​‐ Need 24-hr access to
Reticu​locyte Count ations, overex​‐ facility that specia​lizes
ertion, & stress in SCA
↑ greatly
Report & Seek Immediate Medical
Peripheral Blood Smear
Attention:
Presence of sickle​-shaped cells & target - Suspected pain crisis
cells - Febrile illness
Platelet Count, Erythr​ocyte Sedime​ntation - Pale, listle​ssness, ↑ fatigue
Rate, - Unusual headache, loss of feeling, sudden
weakness (stroke)
↑
- Sudden vision changes
LFTs
- Cough, SOB, chest pain (ACS)
↑ bilirubin - Limp or swollen joints
X-Ray Studies or Scans - Painful erection that won’t go down
(priapism)
Determine extent of organ or tissue
- Symmetric swelling of hands & feet in
damage d/t vaso-o​ccl​usion
(dacty​litis)
K+
↑ d/t hemolysis of RBCs after transf​‐
usion

Pulmonary Infiltrate
W/ ACS

Collab​orative Care & Meds

Stem cell transplant Splene​ctomy

Prophy​lactic ABX Immuni​zations
Analgesics O2
IV fluids PRBCs
Hydrox​yurea

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