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Copy of Nursing Care Plan - Sickle Cell Anemia

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by

Joyce Lin

on 5 April 2014

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Transcript of Copy of Nursing Care Plan - Sickle Cell Anemia

45 Year Old Female

No Known Allergies


Surgery - February 26th, 2014

Left Total Hip Arthoplasty
Ms. O
Hx: Sickle Cell Anemia
RED BLOOD CELLS aka ERYTHROCYTES
Main Function:

to carry and distribute oxygen and proteins throughout the body
Additional Information:
states that she may have trouble breahing when a sickle cell crisis occurs
What is Sickle Cell Anemia Exactly?
Sickle cell anemia
is
a genetically inherited disorder
the red blood cells’ ability to carry oxygen is reduced or compromised
Main Complications:
sickle cell crisis (periods of acute pain)
This crisis can be caused by various factors such as hypoxia or deoxygenation of the RBC
Commonly induced by infection, emotional/physical stress and/or blood loss.
Another factor that may result in a crisis would be dehydration.
Three Nursing Diagnoses

1. Ineffective tissue perfusion related to sickle cell crisis

2. Acute pain related to sickle cell crisis

3. Ineffective breathing pattern related to sickle cell crisis


Priority Health Problem

Poor tissue perfusion!

Nursing Interventions
• Monitor oxygenation and provide oxygen if O2 is <94%

• Assess vital signs and mental status

• Provide hydration orally or through IV fluids

• Perform capillary refill test

• Check lab values – Hgb, Hct and RBC levels – and compare with baseline values

• Pain management

• Monitor surgical incision and dressing for any signs of bleeding or drainage

• Blood transfusion therapy - if ordered
Expected Outcomes
• Within 10 minutes, patient’s oxygenation saturation level will have risen to above 94%

• Within 30 minutes, patient’s blood pressure will have increased

• Hemoglobin and hematocrit levels will be back within normal range

References
Lewis, S. M., Dirksen, S. R., Heitkemper, M. M., Bucher, L. & Camera, I. M. (2014). Medical-surgical nursing in Canada: Assessment and management of clinical problems (3rd Canadian ed.). (M.A. Barry, S. Goldsworthy & D. Goodridge, Canadian Eds.). Toronto, ON: Mosby.

Lippincott (2013). Nursing 2014 drug handbook. Philadelphia, PA: Lippincott

Maakaron, J.E. (2013). Sickle cell anemia. Retrieved from http://emedicine.medscape.com/article/205926-overview

Pagana, K. D., & Pagana, T. J. (2013). Mosby's Canadian manual of diagnostic and laboratory tests (1st Canadian ed.) (S. A. Pike-MacDonald, Canadian Ed.), Toronto ON: Mosby

Potter, P. A., & Perry, A. G. (2010). Canadian fundamentals of nursing (Revised 4th ed.) (J. C. Ross-Kerr & M. J. Wood, Canadian Eds.). Toronto, ON: Mosby.

Roy, C., & Andrews, H. (2009). The Roy Adaptation model (3rd ed.): New Jersey, NY: Pearson.

Now let's discuss!
Previously, I listed out my Nursing Interventions, BUT I purposely did not give my rationale...hehehe
Here they are again...
• Monitor oxygenation and provide oxygen if O2 is <94%

• Assess vital signs and mental status

• Provide hydration orally or through IV fluids

• Perform capillary refill test

• Check lab values – Hgb, Hct and RBC levels – and compare with baseline values

• Pain management

• Monitor surgical incision and dressing for any signs of bleeding or drainage

• Blood transfusion therapy - if ordered
Nursing interventions
What are your rationales for these interventions?
Thank you for listening and participating!
Full transcript