Paper Example on Pathophysiology of Sickle Cell Disease

Nisha's clinical manifestations

Sickle cell Anemia has manifested with her low level of oxygen saturation, low-grade fever, low Hct, and hemoglobin. With all that it is a clear indication of vasooclusive crisis.

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Pathophysiology of Sickle Cell Disease

In sickle cell anemia, the red blood cell changes their molecular structure from biconcave to long slim crystals when there is a condition of dehydration, hypoxia, acidosis and increased temperature (Piel, Steinberg & Rees, 2017). That leads to the obstruction that is caused by vascular inflammation that causes elevated white blood cells, high red blood cells destruction, and sickled cells. When the sickled cells are blocked and are accompanied by inflammation blocks microcirculation leads to vas occlusion which is very painful (Piel, Steinberg & Rees, 2017).

Sickle cell crises

Sickle cell crises is a situation that is characterized by ischemia and may cause mild or severe pain that may be short term or long term. That occurs when the sickled RBC block the tiny blood vessels which carry the blood to the bones. That happens because of several exacerbation periods (DeBaun & Strunk, 2016).

Other assessment data would be helpful for the nurse to have to prepare Nisha's plan of care

In case the patient had asthma or any other comorbidities. Also if the patient had any bone pain. A CT or US of the patient's spleen to test for splenomegaly. Neurological examination I also useful, due to the risk of stroke. Urine cultures can also be used since she has a low-grade fever (Piel, Steinberg & Rees, 2017).

The priorities of care for Nisha on admission

Nisha's priority of care is to have her oxygen level sat up to above 93. That will ensure that all her tissues get sufficient oxygen.

Why or why not the nurse would implement them

The VS is done to prevent the temperature of the patient from rising due to infections since she is at a high risk of disease due to splenomegaly caused by sickle cell anemia. For Nisha's oxygen utilization to rise she has to be put on bed rest. She also has to stay hydrated since dehydration is a major cause of exacerbation. Also since she is in pain, she must be put under analgesic to relieve her from the severe pain caused by vasoocclusion (DeBaun & Strunk, 2016).

Nursing interventions would be appropriate in meeting Nisha's needs

Nurses should administer analgesics to relieve the patient from pain. They should also palpate the spleen to check for enlargement and do a neurological assessment.

Impressions of Nisha's condition based on her level of growth and development

Nisha seems to be in Erikson's identity and role confusion stage, and she is also developing a personal sense. Most likely she might be viewing herself as a failure.

Teaching priorities for Nisha before her discharge from the hospital after her crises is resolved

Nisha needs education on the thing that can exacerbate her condition like; temperature changes, dehydration and rest breaks during physical exercise. Her parents should also be taught on spleen palpating and should be told to top their child from sports to avoid spleen enlargement due to rupture. They should also be educated on proper hygiene, proper nutrition and often medical checkup.

References

Piel, F. B., Steinberg, M. H., & Rees, D. C. (2017). Sickle cell disease. New England Journal of Medicine, 376(16), 1561-1573.

DeBaun, M. R., & Strunk, R. C. (2016). The intersection between asthma and acute chest syndrome in children with sickle-cell anaemia. The Lancet, 387(10037), 2545-2553.