Summary NUR 2214 Study Guide Summer 2020 Exam 3

NUR 2214 Study Guide Summer 2020 Exam 3 Sickle Cell Anemia • Definition/Pathophysiology o The clinical features of SCA are primarily the result of  (1) obstruction caused by the sickled RBCs with other cells  (2) vascular inflammation  (3) Increased RBC destruction,****** abnormal adhesion, entanglement, and enmeshing of rigid sickle-shaped cells accompanied by the inflammatory process intermittently blocks the microcirculation causing vaso-occlusion. • The resultant absence of blood flow to adjacent tissues causes local hypoxia, leading to tissue ischemia and infarction (cellular death). • Pathologic changes o Pain is most common symptom o Cardiovascular changes – risk for high cardiac output, SOB, general fatigue, increase jugular venous distension, increase HR, low to normal BP o Respiratory changes – occur over time – usually pts develop pulmonary hypertension, and all are at risk for recurrent pneumonia  Acute chest syndrome is a common life-threatening condition that is usually associated with respiratory infection and can also be caused by fat embolism and pulmonary debris from sickled cells. Symptoms are similar to pneumonia with: • Cough, shortness of breath, abnormal breath sounds, and an infiltrate on chest x-ray, Chest pain, fever, cough, tachypnea, wheezing, and hypoxia • Fever may or may not be present. • Without intervention, this complication can lead to respiratory failure and failure of all other organ systems. o Abdominal changes - damage to the spleen and liver, pain from reduced PERFUSION is diffuse and steady, also involving the back and legs.  The liver or spleen may feel firm and enlarged with a nodular or “lumpy” texture in later stages of the disease.