Heme Case Essay

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Case Study—Hematology Jade is a 14 year old with sickle cell anemia. She lives with her mother and grandmother in a rural neighborhood. Jade has experienced several "sickle cell crises", however, they seem to have become more frequent since she became an adolescent. Jade is enjoying her summer break from school. She is active in softball and enjoys shopping with her girlfriends. Jade's mother brings her to the hematology clinic at the hospital with complaints of severe generalized pain following a softball game in which she pitched seven innings. She is admitted to the medical pediatric unit. Her vital signs are: temperature, 37.6° C (99.7° F); pulse 110 beats/minute; respirations, 30 breaths/minute; and blood pressure, 96/70. She weighs 110 lb. Her complete blood count reveals: hemoglobin, 9 g/dL (low); hematocrit, 24% (low); white blood cell count, 12,000 cells/ mm3 (high); and platelet count, 140,000 cells/ mm3 (low). Her oxygen saturation is 89%.(low) 1. Discuss your impressions of Jade's clinical manifestations. • My impression of Jades clinical manifestations is that she is experiencing a sickle cell crisis. Jane’s labs also reveal she is having a vaso-occlusive crisis. 2. What is a sickle cell crisis? Why is it concerning? • A sickle cell crisis is when the RBC is sickled shaped which prevents the RBC’s and oxygen to get to the tissue leading to extreme pain. There are 3 forms of a sickle cell crisis: • Vaso-occlusive crisis occurs when blood flow to tissues is obstructed by sickled RBCs, leading to hypoxemia and ischemia. • Acute sequestration event occurs when blood flow from an organ such as the liver, lungs, or spleen is obstructed by sickled RBC. with potential respiratory failure. • Aplastic event occurs when there is an increased destruction or decreased production of RBCs. 3. What other assessment data would the nurse have to

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