Question

a 39-year-old black man who has sickle cell disease (SCD) marked by frequent episodes of severe pain. His anemia has been managed with multiple transfusions, and he shows signs of chronic renal failure. He is a nonsmoker, nondrinker, and is on Social Security disability. His regular medications are pentoxifylline (Trental), oxycodone/acetaminophen (Roxicet), and folic acid (Folvite). In hematology clinic this AM, V.M.’s Hgb measured 6.7 g/dl. He received 2 units PRC (packed rerd cells) over 3 hours and then went home. V.M. developed dyspnea and shortness of breath approximately 1 to 1 ½ hours later, and his wife called 911. The EMS (emergency medical system) crew-initiated oxygen and transported V.M. to the ED.

V.M.’s ABG’s on 9 L O2/ simple face mask are pH 7.34, PaO2 74mmHg, Pa CO2 33mmHg, HCO3 18 mEq/L, BE -6. Is V.M being adequately oxygenated, why or why not? (2.5 points)

Answer 1

V.M., a 39 year old African American, had sickle cell disease (SCD) along with severe pain. His anemia was managed with multiple transfusions. He was diagnosed with signs of chronic renal failure, 6 months ago. He was regularly medicated. He was measured for his hemoglobin levels, which were less. So, he received 2 units of packed red blood cells (PRBCs) for over 3 hours and then he went home.

After reaching home 1 hour later, he was developed with shortness of breath and dyspnea. His wife had called the emergency number. The medical emergency system crew people initiated him with oxygen through nasal cannula and had taken him to the emergency department (ED).

Red blood cells (RBCs) contain hemoglobin, oxygen carrying protein in the blood cells. Normal RBCs are flexible and round in shape. SCD, stated as genetic disorder of the blood. Its common type is called as Sickle Cell Anemia (SCA). It is caused due to abnormal hemoglobin.

Hemoglobin is a protein that carries oxygen. It is found in RBCs. It leads to sickle shape of the RBCs, which is rigid. It is basically a mutated gene. These types of tissues or organs could lead to damage of spleen, brain, kidneys and many more. SCSs complications is increased pressure of blood in the blood vessels, a state known as pulmonary hypertension

SCSs had evolved from a gene resistant to Malaria. In the areas of regions of the Malarial belt like, Southern Europe and Asia, Middle East and many more, the gene flourished. It was the progress of resistance of Malaria, negative impact of this disease was shown.