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What nursing implications does this have

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What nursing implications does this have?Complications: HTN (30% of patients) , MI, TIA, Stroke;DVTDate April 201831
Copyright © 2018 Wolters Kluwer · All Rights ReservedNURSING INTERVENTIONSNURSING INTERVENTIONSTEACHINGoFOLLOW UPVISITSoSIGNS ANDSYMPTOMS OFINFECTIONoLIFE LONGDIETARYCHANGESoLIFELONGMEDICATIONREGIME
Copyright © 2018 Wolters Kluwer · All Rights ReservedHemolytic Anemiasexcess destruction of RBCsCaused by altered erythropoiesis, or other causes such ashypersplenism, drug-induced or autoimmune processes,mechanical heart valvesHemolytic Anemiasexcess destruction of RBCsCaused by altered erythropoiesis, or other causes such ashypersplenism, drug-induced or autoimmune processes,mechanical heart valvesSickle cell diseaseThalassemiaGlucose-6-phosphate dehydrogenase deficiencyP 942Immune hemolytic anemiapage 943Hereditary hemochromatosis pagepage 944Others (refer to Chart 33-1)page 926
Copyright © 2018 Wolters Kluwer · All Rights ReservedSICKLE CELL DISEASE (SCD)SICKLE CELL DISEASE (SCD)GENETICoAbnormal hgb.chainsoSickled cells becomerigid and clumptogetheroBlock blood flowHIGH RISK GROUPoAFRICAN-AMERICANS
Copyright © 2018 Wolters Kluwer · All Rights ReservedNursing Process: The Patient With SickleCell Disease—AssessmentNursing Process: The Patient WithSickleCell Disease—AssessmentHealth history and physical examPain assessmentLaboratory data: S-shaped hemoglobinPresence of symptoms and impact of those symptoms onpatient’s life; swelling, fever, painSickle cell crisis assessmentBlood loss: menses, potential GI lossCardiovascular and neurologic assessment
Copyright © 2018 Wolters Kluwer · All Rights ReservedSCD: PAIN AND PAIN CONTROL IS A BIG ISSUE!!!SCD: PAIN AND PAIN CONTROL IS A BIG ISSUE!!!cs(1 MINUTE)Kwo&NR=1(39 SECONDS)MVw&NR=1(2.26 MINUTES) Good case study.Date April 201836
Copyright © 2018 Wolters Kluwer · All Rights ReservedCollaborative Problems and PotentialComplicationsCollaborative Problems and PotentialComplicationsHypoxia, ischemia, infectionDehydrationCVAAcute and chronic kidney diseaseHeart failureImpotencePoor complianceSubstance abuse
Copyright © 2018 Wolters Kluwer · All Rights ReservedREPEATED CRISIS RT Poor Perfusion andOxygenationREPEATED CRISIS RT Poor Perfusion andOxygenationCARDIOVASCULAR CHANGESoSTOKE, Acute Chest SyndromeoPERIPHERAL ULCERATIONoPRIAPISM (painful penile erection)CHANGES IN BONE DENSITYINCREASED DEMAND ON BONE MARROWoANEMIA, INFECTION, BLEEDINGSPLEEN AND KIDNEY DAMAGEoPulmonary HTN, CKD38Date April 201838
Copyright © 2018 Wolters Kluwer · All Rights ReservedTREATMENT: Supportive CareTREATMENT: Supportive CarePAINFUL: GiveMorphine (Opioidaddiction is rare)o2-5%oSevere enough torequirehospitalizationoPCAOXYGEN– via deliverydevice – lack of oxygenmay cause of sicklingHYDRATION– IVs oflarge volumes (250 mLsof hypotonic solution)DRUG TXoHydroxyureaReducessickling/painstimulating HbFochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=hemoglobin_fetalPREVENT INFECTIONBLOOD TRANSFUSIONSDate April 201839

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Hematology, Monitor

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