Anthony Perkins, 15 years old
Sickle Cell Anemia Primary Concept Perfusion Interrelated Concepts (In order of emphasis)
1.Pain
2.Clotting 3.Fluid and Electrolyte Balance
4.Clinical Judgment
5.Patient Education
6.Communication
Sickle Cell Crisis History of Present Problem: Anthony Perkins is a 15-year-old African American male who was at a medically monitored summer camp and participated in several sports activities when the outside temperature was greater than 90 degrees. He began having pain in
his knees and was evaluated by the camp nurse. After evaluation, he was transported to his primary care provider and evaluated. Anthony was transferred as a direct admit to the pediatric floor of the community hospital where you are the primary nurse responsible for his care. He weighs 154 lbs or 70 kg. Personal/Social History: Anthony was diagnosed with sickle cell anemia at birth during a routine newborn screening. He was a term newborn with normal childhood illnesses. He has been hospitalized with pneumonia four times – at age 8, 9, 11, and 14. He is up to date
on childhood immunizations, and recently received his pneumococcal and influenza vaccines. Anthony has had multiple hospitalizations for sickle cell crises and transfusions. He lives with his parents and two siblings, a younger brother (9 years old), and sister (4 years old). His family lives in a three-bedroom, two-bath home. Anthony’s father is an accountant and the sole financial provider of the family. Anthony’s mom stays home, raising the children. The family is covered by a private medical insurance PPO through Anthony’s father’s employer. 1.What data from the histories are important and RELEVANT and have clinical significance for the nurse? (5 points)
RELEV ANT Data from Present Problem: Clinical Significance: -Participated in several sports activities -Outside temperature was greater than 90 degrees-Generally sport activities involve being physically active, running around, and getting the blood pumping. Activities like this will increase the oxygen demands of the body which can trigger the sickling of red blood cells.
-The high outdoor temperature indicates the patient probably was sweating a lot will he was engaging in the activities. This could lead to a decrease in fluid volume which increases the viscosity of the blood and the chance for clotting, RELEV ANT Data from Social History: Clinical Significance: -Hospitalized with pneumonia four times
-Up to date on childhood immunizations and recent pneumococcal and influenza vaccines.
-Multiple hospitalizations for sickle cell crisis and transfusions -This is likely due to the patients increased risk for infections. Proper infection control steps should be taken to prevent any hospital acquired infections.
-Being up to date on immunizations and vaccinations is very important
for people with sickle cell due to the increased risk for infections. The pneumonia vaccine is particularly important because he has been hospitalized four times in the past 7 years.
-Multiple hospitalizations could indicate the patient does not have a good handle on his disease and may need more education. The patient has required transfusions during his previous crisis which may indicate the need for a transfusion to correct his current crisis. 2.What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds? (Which medication treats which condition? Draw lines to connect.) (5 points)
PMH: Home Meds: Pharm. Classification: Expected Outcome: *Sickle cell anemia 1.Folic Acid 1 mg po
daily 2.Hydroxycarbamide 200 mg po daily 1. Water soluble vitamin
2. Antimetabolite 1. Increase the number of red blood cells produced.
2. Decrease the formation of sickle-shaped red blood cells.
Sickle Cell Anemia Primary Concept Perfusion Interrelated Concepts (In order of emphasis)
1.Pain
2.Clotting 3.Fluid and Electrolyte Balance
4.Clinical Judgment
5.Patient Education
6.Communication
Sickle Cell Crisis History of Present Problem: Anthony Perkins is a 15-year-old African American male who was at a medically monitored summer camp and participated in several sports activities when the outside temperature was greater than 90 degrees. He began having pain in
his knees and was evaluated by the camp nurse. After evaluation, he was transported to his primary care provider and evaluated. Anthony was transferred as a direct admit to the pediatric floor of the community hospital where you are the primary nurse responsible for his care. He weighs 154 lbs or 70 kg. Personal/Social History: Anthony was diagnosed with sickle cell anemia at birth during a routine newborn screening. He was a term newborn with normal childhood illnesses. He has been hospitalized with pneumonia four times – at age 8, 9, 11, and 14. He is up to date
on childhood immunizations, and recently received his pneumococcal and influenza vaccines. Anthony has had multiple hospitalizations for sickle cell crises and transfusions. He lives with his parents and two siblings, a younger brother (9 years old), and sister (4 years old). His family lives in a three-bedroom, two-bath home. Anthony’s father is an accountant and the sole financial provider of the family. Anthony’s mom stays home, raising the children. The family is covered by a private medical insurance PPO through Anthony’s father’s employer. 1.What data from the histories are important and RELEVANT and have clinical significance for the nurse? (5 points)
RELEV ANT Data from Present Problem: Clinical Significance: -Participated in several sports activities -Outside temperature was greater than 90 degrees-Generally sport activities involve being physically active, running around, and getting the blood pumping. Activities like this will increase the oxygen demands of the body which can trigger the sickling of red blood cells.
-The high outdoor temperature indicates the patient probably was sweating a lot will he was engaging in the activities. This could lead to a decrease in fluid volume which increases the viscosity of the blood and the chance for clotting, RELEV ANT Data from Social History: Clinical Significance: -Hospitalized with pneumonia four times
-Up to date on childhood immunizations and recent pneumococcal and influenza vaccines.
-Multiple hospitalizations for sickle cell crisis and transfusions -This is likely due to the patients increased risk for infections. Proper infection control steps should be taken to prevent any hospital acquired infections.
-Being up to date on immunizations and vaccinations is very important
for people with sickle cell due to the increased risk for infections. The pneumonia vaccine is particularly important because he has been hospitalized four times in the past 7 years.
-Multiple hospitalizations could indicate the patient does not have a good handle on his disease and may need more education. The patient has required transfusions during his previous crisis which may indicate the need for a transfusion to correct his current crisis. 2.What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds? (Which medication treats which condition? Draw lines to connect.) (5 points)
PMH: Home Meds: Pharm. Classification: Expected Outcome: *Sickle cell anemia 1.Folic Acid 1 mg po
daily 2.Hydroxycarbamide 200 mg po daily 1. Water soluble vitamin
2. Antimetabolite 1. Increase the number of red blood cells produced.
2. Decrease the formation of sickle-shaped red blood cells.
