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  /Title (nursing-study-guide-sickle-cell-anemia.pdf)
  /Creator (Cheatography)
  /Author (helpmee)
  /Subject (Nursing Study Guide - Sickle Cell Anemia Cheat Sheet)
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    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Nursing Study Guide - Sickle Cell Anemia Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{helpmee} via \textcolor{DarkBackground}{\uline{cheatography.com/148061/cs/32233/}}}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}helpmee \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 29th May, 2022.\\
   Updated 29th May, 2022.\\
   Page {\thepage} of \pageref{LastPage}.
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  Measure your website readability!\\
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\begin{multicols*}{3}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Pathology}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Most common hemoglobinopathies \{\{nl\}\} - RBCs do not carry the normal Hgb but instead carry a less effective type} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Severe chronic blood disorder that occurs 1/2,000 per year in U.S} \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Glutamic acid is replaced w/ valine in Hgb molecule → elongated RBC that is rigid \& sickle w/ a shortened life spa} \tn 
% Row Count 8 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Significant anemia may occur when RBCs sickle} \tn 
% Row Count 9 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{When cells sickle, blood becomes more viscous b/c cells clump together \& prevent normal blood flow to the tissues of that area since their shape cannot pass through the smaller capillaries \& venules → vaso-occlusive process leads to local tissue hypoxia → ischemia → infarction \& pain crisis} \tn 
% Row Count 15 (+ 6)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Hemolysis occurs following sickling} \tn 
% Row Count 16 (+ 1)
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Etiology / Risk Factors}}  \tn
% Row 0
\SetRowColor{LightBackground}
Inherited autosomal recessive pattern & African (1 in 400, 8\% carry trait), Mediterranean, Middle Eastern, \& Indian descent \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
Passed on when both parents have gene or trait & May be triggered by stress or traumatic event \tn 
% Row Count 8 (+ 3)
% Row 2
\SetRowColor{LightBackground}
25\% risk of Hgb SS, 25\% Hgb AA, 50\%  Hgb AS & Infection, fever, acidosis, dehydration, physical exertion, excessive cold exposure, hypoxia \tn 
% Row Count 13 (+ 5)
% Row 3
\SetRowColor{white}
Hgb AS = carrier \& usually have only minimal health problems & - \tn 
% Row Count 16 (+ 3)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Complications}}  \tn
% Row 0
\SetRowColor{LightBackground}
Cardiomegaly, fxn murmur & Pulmonary HTN, Restrictive lung disease \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Retinopathy & Cholelithiasis \& gallstones \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
Jaundice, hepatomegaly & Functional Asplenia \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
Chronic leg ulcers & MODs common in adulthood \tn 
% Row Count 8 (+ 2)
% Row 4
\SetRowColor{LightBackground}
Stroke & Sepsis \tn 
% Row Count 9 (+ 1)
% Row 5
\SetRowColor{white}
Delayed G\&D \& puberty & Organs \tn 
% Row Count 11 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Signs \& Symptoms}}  \tn
% Row 0
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\mymulticolumn{2}{x{5.377cm}}{Infants asymptomatic until 3-4 months d/t Hgb F protection (later half of 1st year of life)} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Pain crisis, recurrent pain episodes (vaso-occlusive) \{\{nl\}\} - ↑ tachycardia \& tachypnea → more sickling \{\{nl\}\} - Most common in joints (hot, swollen) & Acute Chest Syndrome (ACS) \{\{nl\}\} - Cell clumping in lungs \{\{nl\}\} - ↓ gas exchange → hypoxia, wheezing, cough, chest pain, fever → more sickling \tn 
% Row Count 10 (+ 8)
% Row 2
\SetRowColor{LightBackground}
Aplastic crisis (profound anemia) & Dactylitis (hand-foot syndrome), aseptic infarction \tn 
% Row Count 13 (+ 3)
% Row 3
\SetRowColor{white}
Pale mucous membranes & Easily fatigued w/ poor appetite \tn 
% Row Count 15 (+ 2)
% Row 4
\SetRowColor{LightBackground}
↓ BP d/t severe anemia or ↑ BP d/t SC nephropathy & Acute abdominal pain (most common) d/t sludging \& splenomegaly \tn 
% Row Count 19 (+ 4)
% Row 5
\SetRowColor{white}
Sequestration crisis / Splenic sequestration \{\{nl\}\} - Pooling of blood in liver \& spleen w/ ↓ blood volume \& shock & Bacterial meningitis or sepsis \tn 
% Row Count 25 (+ 6)
% Row 6
\SetRowColor{LightBackground}
 & Bone infarction \tn 
% Row Count 26 (+ 1)
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Nursing Interventions}}  \tn
% Row 0
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Immunizations \& ABX to ↓ risk of infection & Tx underlying cause (infection) \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
H-O-P to it! → Hydration, O2, Pain relief & O2 during episodes of crisis to prevent further sickling \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
↑ fluids to promote hemodilution, 150 mL/kg/day or double maintenance w/ hypotonic, D5W or D5 w/ 0.25\% NS & Adequate pain management helps ↓ stress; always believe pain level \tn 
% Row Count 12 (+ 6)
% Row 3
\SetRowColor{white}
NO PRN pain meds, use fix dose, can use w/ non-pharmacologic techniques & Assess pain w/ the right pain tool \& look for complications of pain \tn 
% Row Count 16 (+ 4)
% Row 4
\SetRowColor{LightBackground}
Assess for S/S of ineffective tissue perfusion & Avoid sudden temp change (cooling mattress for fever) \tn 
% Row Count 19 (+ 3)
% Row 5
\SetRowColor{white}
Cluster care & Quiet environment \& privacy \tn 
% Row Count 21 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Diagnostics}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Sickle-Turbidity Test (Sickledex) finger stick} \tn 
\mymulticolumn{1}{x{5.377cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}Possibility or SCA or SC trait} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Hgb Electrophoresis} \tn 
\mymulticolumn{1}{x{5.377cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}Dx, only accurate test for SCA} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Hgb} \tn 
\mymulticolumn{1}{x{5.377cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}\textasciitilde{}6-9 mg/dL (normal 11-15 in infant) \{\{nl\}\} Significantly lower w/ splenic sequestration, ACS, or aplastic crisis} \tn 
% Row Count 8 (+ 4)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Reticulocyte Count} \tn 
\mymulticolumn{1}{x{5.377cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}↑ greatly} \tn 
% Row Count 10 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Peripheral Blood Smear} \tn 
\mymulticolumn{1}{x{5.377cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}Presence of sickle-shaped cells \& target cells} \tn 
% Row Count 12 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Platelet Count, Erythrocyte Sedimentation Rate,} \tn 
\mymulticolumn{1}{x{5.377cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}↑} \tn 
% Row Count 14 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{LFTs} \tn 
\mymulticolumn{1}{x{5.377cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}↑ bilirubin} \tn 
% Row Count 16 (+ 2)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{X-Ray Studies or Scans} \tn 
\mymulticolumn{1}{x{5.377cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}Determine extent of organ or tissue damage d/t vaso-occlusion} \tn 
% Row Count 19 (+ 3)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{K+} \tn 
\mymulticolumn{1}{x{5.377cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}↑ d/t hemolysis of RBCs after transfusion} \tn 
% Row Count 21 (+ 2)
% Row 9
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Pulmonary Infiltrate} \tn 
\mymulticolumn{1}{x{5.377cm}}{\hspace*{6 px}\rule{2px}{6px}\hspace*{6 px}W/ ACS} \tn 
% Row Count 23 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
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\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Collaborative Care \& Meds}}  \tn
% Row 0
\SetRowColor{LightBackground}
Stem cell transplant & Splenectomy \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Prophylactic ABX & Immunizations \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
Analgesics & O2 \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
IV fluids & PRBCs \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Hydroxyurea} \tn 
% Row Count 5 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Teaching}}  \tn
% Row 0
\SetRowColor{LightBackground}
Family support as they often feel guilty or responsible & Promote wireless communication w/ NP for collab \& coaching \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
Disease process, complications, genetics, testing for carrier status & Regular health maintenance visits, immunizations, PCN, coping, adequate fluids \tn 
% Row Count 7 (+ 4)
% Row 2
\SetRowColor{LightBackground}
Avoid temp fluctuations, overexertion, \& stress & Need 24-hr access to facility that specializes in SCA \tn 
% Row Count 10 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Report \& Seek Immediate Medical Attention: \{\{nl\}\} - Suspected pain crisis \{\{nl\}\} - Febrile illness \{\{nl\}\} - Pale, listlessness, ↑ fatigue \{\{nl\}\} - Unusual headache, loss of feeling, sudden weakness (stroke) \{\{nl\}\} - Sudden vision changes \{\{nl\}\} - Cough, SOB, chest pain (ACS) \{\{nl\}\} - Limp or swollen joints \{\{nl\}\} - Painful erection that won't go down (priapism) \{\{nl\}\} - Symmetric swelling of hands \& feet in (dactylitis)} \tn 
% Row Count 19 (+ 9)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

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