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Disk-shaped red blood cells become sickle shaped
Misshapen cells more fragile than normal red blood cells; as a result, the sickled cells easily rupture as they pass through small capillaries, resulting in a chronic anemia
Cells become stuck in the small capillaries, obstructing blood flow

Sickle Cell Anemia


how do you get sickle cell anemia

Genetic disease: almost exclusively in African Americans
Carried on a recessive gene; a person must inherit the gene from both the mother and the father to actually have the disease


Sickle cell crisis is where

the sickled cells become stuck in larger blood vessels of the body; obstruct blood flow and cause severe pain


Various stressors can trigger a sickle cell crisis what are they

Dehydration, infection, overexertion, cold weather changes, excessive alcohol consumption, smoking


s/s of sickle cell anemia

Symptoms vary: depend on where circulation is blocked by the sickled red blood cells
Circulation to the chest, abdomen, bones, joints, bone marrow, brain, or penis may be compromised
Tissue hypoxia occurs, causing severe pain


Medical diagnosis of sickle cell disease

Physicians use clinical judgment
Radiographs and scans of the painful area to evaluate for bleeding


Medical treatment of sickle cell crisis

There is no cure; treatment is symptomatic
Intravenous fluids and pain medication
Red blood cell transfusions correct the anemia and help the body oxygenate tissues
Oxygen therapy


Assessment of sickle cell anemia

Complete description of the pain
Document location, intensity, duration, and precipitating events; vital signs every 4 hours
Assess for fever
Any symptoms of an infection, such as sore throat, cough, abnormal breath sounds, dysuria, or diarrhea
Monitor for signs and symptoms of dehydration


Interventions of sickle cell anemia

Acute Pain
Risk for Injury
Ineffective Therapeutic Regimen Management


Too few platelets circulating in the blood
Not enough platelets being made in bone marrow or too many platelets are being destroyed in circulation



Major cause:thrombocytopenia:

treatment with chemotherapy or radiation therapy


Examples of too many platelets being either destroyed or consumed are

idiopathic thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP


s/s thrombocytopenia:

Symptoms: petechiae and purpura, gingival bleeding, epistaxis (nosebleeds), or any other unusual or prolonged bleeding


Treatment for thrombocytopenia:

treat or stop the causative factor


A hypercoagulable state
Overstimulation of normal coagulation cascade: simultaneous thrombosis and hemorrhage



Always secondary to another pathologic process of

overwhelming sepsis, shock, major trauma, crush injuries, burns, cancer, acute tumor lysis syndrome, or obstetric complications


Coagulation occurs at so many sites that eventually

all available platelets and clotting factors are depleted and uncontrolled hemorrhage results


Blood tests that help diagnose DIC includes

prothrombin time, partial thromboplastin time, fibrinogen, thrombin time, fibrin split products level, and D-dimer


treatment Coagulation

Blood component replacement therapy
Heparin to interrupt the DIC cycle and allow the body to replenish platelets and clotting factors


Genetic disease: affected person lacks some blood clotting factors normally found in plasma



Signs and symptoms Hemophilia

Uncontrollable bleeding is the hallmark of hemophilia
Occurs after trauma; however, also spontaneously for no clear reason
Commonly, bleeding occurs into the joints, causing swelling and severe pain
Also can occur into the skin; from the mouth, gums, and lips; and from the gastrointestinal tract


Medical diagnosis Hemophilia

Measuring factors VIII and IX in the blood
Partial thromboplastin time


Medical treatment Hemophilia

No cure; treatment is symptomatic
Physician prescribes transfusions of fresh frozen plasma or
cryoprecipitate, or both
Red blood cell transfusions
Intravenous morphine
Physicians try quickly to transition from IV opioids to oral opioids to nonopioid pain relievers as crisis resolves


Assessment Hemophilia

For bleeding and pain; note what measures have stopped the bleeding and relieved pain in the past
Monitor vital signs and urine output


Interventions Hemophilia

Risk for Injury
Acute Pain
Ineffective Therapeutic Regimen Management