Question

Sickle Cell Case Study Assignment

100 points (25 points each)

Kyla is a 12-year-old with sickle cell anemia. She lives with her mother and grandmother in rural neighborhood. Kyla has experienced several “sickle cell crises, “however, they seem to have become more frequent since she became an adolescent. Kyla is enjoying her summer break from school. She is active in softball and enjoys shopping with her girlfriends.

Kyla’s mother brings her to the hematology clinic at the hospital with complaints of severe generalized pain following a lacrosse game in which she played mid-fielders. She is admitted to the pediatric clinic.

Her vital signs are temperature 37.6˚ C (99.7 ˚ F); pulse 118 beats/minute; respiration 33 breaths/minute; and blood pressure, 96/70. She weighs 88 lbs. Her complete blood count reveals: hemoglobin 9 g/L; hematocrit 24%, white blood cell count 12,000 cells/mm3 and platelet count 14,000 cells/mm3. Her oxygen saturation is 89%.

Discuss your impressions of Kyla clinical manifestations?

What is sickle cell crisis?

What are the priorities nursing diagnosis of care for Kyla?

Discuss the teaching priorities for Kayla before discharge from the hospital?

Answer 1

1. Kyla is going in for respiratory distress. Her platelet counts, Haemoglobin is low. Her oxygen saturation is also low.
2. Sickle cell anaemia is an inherited red blood cell disorder. It is due to gene mutation that misshapen RBC. RBC is shaped as a sickle which makes it harder to carry enough oxygen. It get caught in the blood vessels and obstructs the flow of blood to the other organs. This causes a painful condition called sickle cell crisis. It happens suddenly.
3. The priority nursing diagnosis are:
• Impaired gas exchange
• Ineffective tissue perfusion
• Risk for deficient fluid volume
• Acute pain
• Risk for impaired skin integrity
• Deficient knowledge
4. The teaching points to be given before discharge are:
• Take the prescribed medications regularly
• Drink about 10 glasses of water a day and more during hot weather and exercising.
• Do light or moderate exercise, avoid strenuous activities.
• Wet warm cloths during cold weather.
• Limit time spent at higher altitudes
• Avoid mountain climbing
• Wash hands often to prevent infection
• Get vaccinated as per schedule
• Take folic acid supplement
• Reduce stress
• Pain can be managed at home with pain killers
• Only if serious complications visit hospital