Question

When caring for a client with sickle cell anemia, list 5 nursing intervention with an explanation of each

Answer 1

Sickle cell anemia is a disease that can be inherited, which causes disorientation in the shape of hemoglobin, a protein present in a red blood cell (RBC). Such issue can lead to sharp and crystal like RBC in their shapes. So, low amount of oxygen for a RBC can lead to such problems. And, after change in shape of RBC, further reduction in oxygen distribution can be seen in a patient. Symptoms of this disease are fever, vasoconstriction, acute chest syndrome and hypovolemic shock etc,.

A nurse who is taking care of a patient, who is suffering from this disease should be able to provide comfort and educate the patient and the family as well. Other than that, specific interventions as follows should also be followed by the same nurse,

1. Assist the patient with his or her posture and mobility

Bed sore or increased pressure on the tissue can occur if a person does not get to undergo movements or due to stable position for a very long time. So, reduction in venous return or blood circulation can occur due to such practice. So, possible changes in posture during bed rest and siting when allowed and provision for pillow for the regions like elbow and heel can provide comfort and proper blood circulation. Water based mattress can be given for the patient to reduce bed sores.

2. Prevention of skin problems

. The skin should be maintained dry to prevent pathogenic infection. Any cut or wound should be healed immediately by providing hyperbaric oxygenation procedure, so that RBC production become normal. Other than that, hydrogen peroxide and iodine can be used on the surface wounds to enhance healing.

3. Record vital signs

Consciousness level is checked time to time because, oxygen reduction can affect activity of one's brain. And, due to hemoglobin defect, bacterial diseases like pneumonia and fever may occur. So, breathing exercises along with packed RBC or perfusion is suggested to increase RBC and oxygen distribution. And, antibiotics are also given from time to time to reduce bacterial disease especially that occurs in lungs.

4. Provide required fluid intake and note down urine output

Sickle cell anemia can cause increase in viscosity of the blood. So, to prevent that adequate amount of fluid intake is suggested. And, any problem in renal function can also lead to dehydration, so incidence for vascular occlusion and dehydration should be checked immediately and possible steps should be taken with the doctor.

5. Provide ventilation and test the patient for pulmonary functions

For this patient, lack of oxygen can lead to further complications. So, it is important to provide humidified oxygen. And, more amount of oxygen also should not be given, because that can lead to reduction in RBC production. Monitoring respiratory rate, breath sounds and cardiac rhythm is vital because, due to changes in RBC and hemoglobin, one's own body can start compensate, which can lead to malfunctioning of lungs and heart. So, any changes in vital signs should be reported immediately.