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Care Plan. 745769 - Essay Example

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NURS 401 NURSING CARE PLAN Part 1 _ Date submitted:_ Patient Initials: S.B Age/Sex: 21 y.o. / Male Medical Diagnosis: Sickle cell anemia I. Etiology and Pathophysiology: Sickle cell anemia is an inherited autosomal recessive trait, more common in African American race, that results in morphologically and functionally abnormal red blood cells…
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Download file to see previous pages Specifically, limitation of tissue oxygenation directly due to a sluggish blood flow is the major pathophysiologic feature of sickle cell anemia. End- organ damage may result when tissue hypoxia is prolonged, which then can lead to death (Smeltzer & Bare, 2006, p. 886). II. Clinical Manifestations (Signs & Symptoms): Severity of the clinical manifestations depends largely on the proportion of RBCs that have sickled. That is, when more cells are sickled, the chances of thrombosis also increase, thus causing decreased oxygen supply to tissues and organs. Pain is one of the most common manifestations as hypoxic tissues generate lactic acid that easily irritates nerve endings and other pain receptors. When the heart tissue is involved, acute chest pain manifests and more commonly associated with tachycardia, fever, falling hemoglobin levels, and sometimes bilateral infiltrates seen on the chest x-ray. Since these cells have relatively shortened life- span, simultaneous hemolysis raises blood bilirubin level up to toxic levels. This is manifested as jaundice. Complications result from chronic hemolysis or thrombosis (Smeltzer & Bare, 2006, p. 887). III. ...
On the other hand, chemotherapy using hydroxyurea increases hemoglobin F levels in affected patients, therefore reducing the formation of sickle cells. Still, there has been no evidence yet if the drug reverses organ damage. Lastly, chronic RBC transfusion is particularly helpful in acute exacerbations of the condition causing severe anemia and infections. However, the patient may also develop complications due to iron overload and thrombosis (Smeltzer & Bare, 2006, p. 888). Nursing interventions are focused on providing continuous pain relief by prompt administration of pain medications prescribed by the physician and helping the client relax and reduce anxiety. Prevention of infection by maintaining a therapeutic environment and using aseptic technique in nursing procedures performed must be an integral part of the care plan. IV. Diagnostic Studies/Lab analysis: Blood tests reveal the presence of sickle RBCs. WBC Count- 9x103/mm3 (N: 3.54-9.06 x103/mm3). Hemoglobin level is 7 mg/ dl (N- 13- 16 mg/dl) which implies anemia and decreased tissue oxygenation, thus, necessitating blood transfusion. Discharge Planning and Client Teaching Continue medications as prescribed by physician. Determine learning needs and educate as necessary especially the common triggers of an exacerbation. Inform S.B. and his mother about his increased risk of acquiring infection and provide directions to prevent it. Caution about severe chest pain and other signs of exacerbations that warrant immediate hospitalization. NURS 401 NURSING CARE PLAN Growth and Development According to Erickson Stage: 6 Crisis: Intimacy vs. isolation (Videbect, 2007, p. 53) I. Describe your patient’s ability to achieve ...Download file to see next pagesRead More
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