Topic 4 DQ 4-1

SICKLE CELL ANEMIA Nichole Luevano, Paula White, Patricia Elizarraraz, Marina Dailey Grand Canyon University NRS-

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434-VN August 12, 2018 ▪ A genetic disorder characterized by defective hemoglobin ▪ The disease affects the red blood cells and their ability to carry oxygen ▪ The affected red blood cells are sticky and look like the letter C ▪ Sickle cells have shorted life span than health cells ▪ Can be a carrier and not have symptoms ▪ Originated with malaria ▪ Symptoms-pain, cold skin, anemia ▪ Diagnosis-blood test and medical screening ▪ Treatment-treating symptoms and preventing infection and complications (Children’s National Health System, 2018) Childhood Adulthood ▪ Immunization ▪ Management ▪ Complications ▪ Treatment ▪ Treatment ▪ Differences ▪ Signs and symptoms (Children’s National Health System [CNHS], 2018). (Miller, 2018) (Pfizer Medical Team, 2014) ▪ Negative outcomes for patients ▪ Effects on relationships ▪ Complications ▪ Goals (Adegbola et al., 2012) (Chan, 2018) This Photo by Unknown Author is licensed under CC BY-NC M ental and Em otional Effects ▪ Stress induced by society’s attitudes and perceptions of sickle cell disease ▪ Health beliefs could be influenced by external factors ▪ Fear of early death and reluctance to confide in family and friends leading to isolation ▪ Mood changes and development of depressive symptoms (Ani, Egunjobi & Akiyanju, 2010) Physical and Sexual Effects ▪ Episodes of Pain ▪ Acute Chest Syndrome ▪ Infections ▪ Anemia (Knott, 2017) ▪ Erectile Dysfunction (in men) ▪ Priapism (in men) (Uzoma & Burnett, 2015) Econom ical Effects Occupational Considerations and Hazards ▪ Increased healthcare costs ▪ Difficulty in executing tasks ▪ Economic burden to healthcare ▪ Decreased level of participation system and client increases related to hospitalizations ▪ Consumption of large percentage of hospital resources ▪ Ineffective outpatient management therefore causing hospital Singh, Jordan & Hanlon, 2014 readmissions ▪ Increased Inactivity due to clinical manifestations (Cunha, Monteiro, Ferreira, Cordeiro & Souza, 2017) ▪ Exposure to extreme temperatures ▪ Frequent urination due to compromised kidney function ▪ Failure to disclose illness due to fear of stigmatization (Sandwell and West Birmingham Hospitals, 2016) Prenatal Care and Childbearing Ability to cope with stress ▪ Woman and Partner should get tested A person affected with sickle cell anem ia m ay find it difficult to deal with the related stresses. T hey m ight want to consider: for sickle cell trait ▪ Prenatal testing for fetus to identify if sickle cell disease or trait exists ▪ Early Prenatal care and monitoring essential for healthy pregnancy (Centers for Disease Control and Prevention, 2018) ▪ Finding someone to confide in and talk to ▪ Exploring different ways to cope with pain ▪ Learning and researching about sickle cell anemia to make informed decisions about care (Mayo Clinic, 2018) SUSCE P T IB IL IT Y TO E NG AG E IN SUB STANCE ABUSE Sickle Cell Anemia patients have severe and recurrent pain crises : ▪ Frequently needing opioids to control pain. ▪ The compromised quality of life can predispose this population to the occurrence of non-psychotic disorders such as depression ▪ Mental Health disorders are making these patients vulnerable to substance abuse. (Santos et el., 2017) www.substanceabusecounselor.com • • Adults with sickle cell anemia will have to live through stiffness, pain, emotional stress, and the unusual sleep patterns that come with these side effects. Although 50% of sickle cell anemia patients have survived and made it past 50 years of age, it is still deadly and treatments and medications will play a role in survival throughout ones lifespan. www.nan.ng Nursing diagnosis: Knowledge deficiency related to improper medical care as evidence by adult rehospitalization According to Live Science, “41 percent of patients ages 18 to 30, diagnosis with Sickle Cell Anemia, who are hospitalized in acute care end up re-hospitalized within 30 days.” (Rettner, 2010) B arriers that can prevent care in Adults clients with sickle cell Anem ia. According to Rettner (2010), ▪ “Care for adults isn’t well established as it is for children.” ▪ “Adults loss health benefits and are unable to pay for care ▪ “Not enough physicians with sickle cell knowledge.” ▪ “Care tends to be not as well coordinated as it is for kids.” Health Prom otion Health Screening I nter ventions • • Find good medical care (Centers for Disease Control and Prevention [CDC], 2017) • Get regular check ups (CDC, 2017) • An increase in Hydroxyurea which “was developed as an anticancer drug and has been used to treat myeloproliferative syndromes.” (Brawley, 2008) Looking for clinical studies (CDC, 2017) • A blood test can check for the defective form of hemoglobin that underlines sickle cell anemia (Keller, 2014) Education for Adults with Sickle Cell Anem ia • • • • Sickle cell Disease is inherited. The disease changes red blood cells into an abnormal shape that cause them to have difficulty when passing through small blood vessels. Sickle cell is one of the most common diseases in the world. The disease does not target any specific race or ethnic background. (John Hopkins Medicine, n.d.) Sickle Cell Disease Association of America, Inc. 231 East Baltimore Street, Suite 800 Baltimore, MD 21202 (410) 528-1555 (800) 421-8453 http://www.sicklecelldisease.org/ A national resource to help provide other resources and services to patients with sickle cell disease such as recommending summer camps for children or group meetings for adults. It also gives general information on the topic and contact information for any questions. JPS Sickle Cell Clinic at JPS Center for Cancer Care 601 W. Terrell Avenue Fort Worth, TX 76104 Adult Care (817) 702-8300 http://www.jpshealthnet.org/health_care_service s/cancer A community resource offering basic clinical needs, radiology, and chemotherapy. The staff there also provides a wide variety of resources for support groups and will accept anyone whether they have insurance or not. Adegbola, M.A., Barnes, D.M., Opollo, J.G., Herr, K., Gray, J. & McCarthy, A.M. (2012). Voices of Adults Living with Sickle Cell Disease Pain. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804106/ Ani, K., Egunjobi, F. & Akiyanju, O. (2010). Psychosocial Impact of Sickle Cell Disorder: Perspective from a Nigerian Setting. National Center for Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836308/ Centers for Disease Control and Prevention. (2017). Sickle Cell Disease. Retrieved from https://www.cdc.gov/ncbddd/sicklecell/healthylivingliving-well.html Centers for Disease Control and Prevention. (2018). What You Should Know About Sickle Cell Disease and Pregnancy. Retrieved from https://www.cdc.gov/ncbddd/sicklecell/documents/scd-factsheet_scd–pregnancy.pdf Chan, Kitty. (2018). Healthcare Access Implications and Psychosocial Effects of Sickle Disease. Retrieved from https://www.inquiriesjournal.com Children’s National Health System. (2018). Pediatric Sickle Cell Disease. Retrieved from https://childrensnational.org/choose-childrens/conditions-andtreatments/blood-marrow/sickle-cell-disease Cunha, J.H.S., Monteiro, C.F., Ferreira, L.A., Cordeiro, J.R. & Souza, L.M.P. (2017). Occupational Roles of individuals with Sickle Cell Anemia. Retrieved from http://dx.doi.org/10.11606/issn.2238-6149.v28i2p230-238 Johns Hopkins Medicine. (n.d.) Patient Education. Retrieved from https://www.hopkinsmedicine.org/Medicine/sickle/patient/index.html Keller, S.D., Yang, M., Treadwell, M.J., Werner, E.M., Hassel, K.L. (2014) Patient Reports of Health Outcome for Adults Living with Sickle Cell Disease: Development and Testing of the ASCQ-Me Item Banks. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25146160 Knott, L. (2017). Sickle Cell Disease: Sickle Cell Anemia. Retrieved from https://patient.info/health/sickle-cell-disease-sickle-cell-anaemia Mayo Clinic. (2018). Sickle Cell Anemia. Retrieved from https://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/diagnosis-treatment/drc20355882 Miller, R. E. (2018). Sickle Cell Disease. Retrieved from https://kidshealth.org/en/teens/sickle-cell-anemia.html Otis W. Brawley, MD; Llewellyn J. Cornelius, PhD, LCSW; Linda R. Edwards, MD; Vanessa Northington Gamble, MD, PhD; Bettye L. Green, RN; Charles Inturrisi, PhD; Andra H. James, MD, MPH; Danielle Laraque, MD; Magda Mendez, MD; Carolyn J. Montoya, RN, MSN, CPNP; Brad H. Pollock, MPH, PhD; Lawrence Robinson, MD, MPH; Aaron P. Scholnik, MD; Melissa Schori, MD, MBA. (2008). National Institutes of Health Consensus Development Conference Statement: Hydroxyurea Treatment for Sickle Cell Disease. Retrieved from http://annals.org/aim/fullarticle/668699/national-institutes-health-consensus-development-conference-statement- hydroxyureatreatment-sickle Pfizer Medical Team. (2014). Managing Sickle Cell Disease as an Adult. Retrieved from https://www.gethealthystayhealthy.com. Primary Psychiatry. (2008). Psychiatric Issues in Adults with Sickle Cell Disease. Retrieved from http://primarypsychiatry.com/psychiatricissues-in-adults-with-sickle-cell-disease/ Rettner, R. (2010). Adults Struggle With What Used to Be Child’s Blood Disorder. Retrieved from https://www.livescience.com/6815- adultsstruggle-child-blood-disorder.html Sandwell and West Birmingham Hospitals. (2014). Employment and Sickle Cell Disease. Retrieved from http://www.swbh.nhs.uk/wpcontent/uploads/2012/07/Employment-and-sickle-cell-disease-ML4367.pdf Santos, M., Travi, D., Ribeiro, C., Pianca, T., Saccilotto, I., Silla, L. & Picon, P. (2017). Pain Management and Substance Abuse in Sickle Cell Disease Patients. International Journal of Technology Assessment in Healthcare, 33, 72-73. DOI:10.1017/S0266462317002057 Singh, R., Jordan, R. & Hanlon, C. (2014). Economic Impact of Sickle Cell Hospitalization. American Society of Hematology Blood Journal. Retrieved from http://www.bloodjournal.org/content/124/21/5971?sso-checked=true Tanyi, R.A. (2003). Sickle Cell Disease: Health Promotion and Maintenance and the Role of Primary Care Nurse Practitioners. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/14560435 Uzoma, A. & Burnett, A. (2015). Sickle Cell Men Are Five Times More Likely to Develop ED with Recurrent Ischemic Priapism. Retrieved from http://www.issm.info/news/sex-health-headlines/sickle-cell-men-are-five-times-more-likely-to-develop-ed-with-recurrent-isc/ SICKLE CELL ANEMIA Nichole Luevano, Paula White, Patricia Elizarraraz, Marina Dailey Grand Canyon University NRS-434-VN August 12, 2018 ▪ A genetic disorder characterized by defective hemoglobin ▪ The disease affects the red blood cells and their ability to carry oxygen ▪ The affected red blood cells are sticky and look like the letter C ▪ Sickle cells have shorted life span than health cells ▪ Can be a carrier and not have symptoms ▪ Originated with malaria ▪ Symptoms-pain, cold skin, anemia ▪ Diagnosis-blood test and medical screening ▪ Treatment-treating symptoms and preventing infection and complications (Children’s National Health System, 2018) Childhood Adulthood ▪ Immunization ▪ Management ▪ Complications ▪ Treatment ▪ Treatment ▪ Differences ▪ Signs and symptoms (Children’s National Health System [CNHS], 2018). (Miller, 2018) (Pfizer Medical Team, 2014) ▪ Negative outcomes for patients ▪ Effects on relationships ▪ Complications ▪ Goals (Adegbola et al., 2012) (Chan, 2018) This Photo by Unknown Author is licensed under CC BY-NC M ental and Em otional Effects ▪ Stress induced by society’s attitudes and perceptions of sickle cell disease ▪ Health beliefs could be influenced by external factors ▪ Fear of early death and reluctance to confide in family and friends leading to isolation ▪ Mood changes and development of depressive symptoms (Ani, Egunjobi & Akiyanju, 2010) Physical and Sexual Effects ▪ Episodes of Pain ▪ Acute Chest Syndrome ▪ Infections ▪ Anemia (Knott, 2017) ▪ Erectile Dysfunction (in men) ▪ Priapism (in men) (Uzoma & Burnett, 2015) Econom ical Effects Occupational Considerations and Hazards ▪ Increased healthcare costs ▪ Difficulty in executing tasks ▪ Economic burden to healthcare ▪ Decreased level of participation system and client increases related to hospitalizations ▪ Consumption of large percentage of hospital resources ▪ Ineffective outpatient management therefore causing hospital Singh, Jordan & Hanlon, 2014 readmissions ▪ Increased Inactivity due to clinical manifestations (Cunha, Monteiro, Ferreira, Cordeiro & Souza, 2017) ▪ Exposure to extreme temperatures ▪ Frequent urination due to compromised kidney function ▪ Failure to disclose illness due to fear of stigmatization (Sandwell and West Birmingham Hospitals, 2016) Prenatal Care and Childbearing Ability to cope with stress ▪ Woman and Partner should get tested A person affected with sickle cell anem ia m ay find it difficult to deal with the related stresses. T hey m ight want to consider: for sickle cell trait ▪ Prenatal testing for fetus to identify if sickle cell disease or trait exists ▪ Early Prenatal care and monitoring essential for healthy pregnancy (Centers for Disease Control and Prevention, 2018) ▪ Finding someone to confide in and talk to ▪ Exploring different ways to cope with pain ▪ Learning and researching about sickle cell anemia to make informed decisions about care (Mayo Clinic, 2018) SUSCE P T IB IL IT Y TO E NG AG E IN SUB STANCE ABUSE Sickle Cell Anemia patients have severe and recurrent pain crises : ▪ Frequently needing opioids to control pain. ▪ The compromised quality of life can predispose this population to the occurrence of non-psychotic disorders such as depression ▪ Mental Health disorders are making these patients vulnerable to substance abuse. (Santos et el., 2017) www.substanceabusecounselor.com • • Adults with sickle cell anemia will have to live through stiffness, pain, emotional stress, and the unusual sleep patterns that come with these side effects. Although 50% of sickle cell anemia patients have survived and made it past 50 years of age, it is still deadly and treatments and medications will play a role in survival throughout ones lifespan. www.nan.ng Nursing diagnosis: Knowledge deficiency related to improper medical care as evidence by adult rehospitalization According to Live Science, “41 percent of patients ages 18 to 30, diagnosis with Sickle Cell Anemia, who are hospitalized in acute care end up re-hospitalized within 30 days.” (Rettner, 2010) B arriers that can prevent care in Adults clients with sickle cell Anem ia. According to Rettner (2010), ▪ “Care for adults isn’t well established as it is for children.” ▪ “Adults loss health benefits and are unable to pay for care ▪ “Not enough physicians with sickle cell knowledge.” ▪ “Care tends to be not as well coordinated as it is for kids.” Health Prom otion Health Screening I nter ventions • • Find good medical care (Centers for Disease Control and Prevention [CDC], 2017) • Get regular check ups (CDC, 2017) • An increase in Hydroxyurea which “was developed as an anticancer drug and has been used to treat myeloproliferative syndromes.” (Brawley, 2008) Looking for clinical studies (CDC, 2017) • A blood test can check for the defective form of hemoglobin that underlines sickle cell anemia (Keller, 2014) Education for Adults with Sickle Cell Anem ia • • • • Sickle cell Disease is inherited. The disease changes red blood cells into an abnormal shape that cause them to have difficulty when passing through small blood vessels. Sickle cell is one of the most common diseases in the world. The disease does not target any specific race or ethnic background. (John Hopkins Medicine, n.d.) Sickle Cell Disease Association of America, Inc. 231 East Baltimore Street, Suite 800 Baltimore, MD 21202 (410) 528-1555 (800) 421-8453 http://www.sicklecelldisease.org/ A national resource to help provide other resources and services to patients with sickle cell disease such as recommending summer camps for children or group meetings for adults. It also gives general information on the topic and contact information for any questions. JPS Sickle Cell Clinic at JPS Center for Cancer Care 601 W. Terrell Avenue Fort Worth, TX 76104 Adult Care (817) 702-8300 http://www.jpshealthnet.org/health_care_service s/cancer A community resource offering basic clinical needs, radiology, and chemotherapy. The staff there also provides a wide variety of resources for support groups and will accept anyone whether they have insurance or not. Adegbola, M.A., Barnes, D.M., Opollo, J.G., Herr, K., Gray, J. & McCarthy, A.M. (2012). Voices of Adults Living with Sickle Cell Disease Pain. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804106/ Ani, K., Egunjobi, F. & Akiyanju, O. (2010). Psychosocial Impact of Sickle Cell Disorder: Perspective from a Nigerian Setting. National Center for Biotechnology Information. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836308/ Centers for Disease Control and Prevention. (2017). Sickle Cell Disease. Retrieved from https://www.cdc.gov/ncbddd/sicklecell/healthylivingliving-well.html Centers for Disease Control and Prevention. (2018). What You Should Know About Sickle Cell Disease and Pregnancy. Retrieved from https://www.cdc.gov/ncbddd/sicklecell/documents/scd-factsheet_scd–pregnancy.pdf Chan, Kitty. (2018). Healthcare Access Implications and Psychosocial Effects of Sickle Disease. Retrieved from https://www.inquiriesjournal.com Children’s National Health System. (2018). Pediatric Sickle Cell Disease. Retrieved from https://childrensnational.org/choose-childrens/conditions-andtreatments/blood-marrow/sickle-cell-disease Cunha, J.H.S., Monteiro, C.F., Ferreira, L.A., Cordeiro, J.R. & Souza, L.M.P. (2017). Occupational Roles of individuals with Sickle Cell Anemia. Retrieved from http://dx.doi.org/10.11606/issn.2238-6149.v28i2p230-238 Johns Hopkins Medicine. (n.d.) Patient Education. Retrieved from https://www.hopkinsmedicine.org/Medicine/sickle/patient/index.html Keller, S.D., Yang, M., Treadwell, M.J., Werner, E.M., Hassel, K.L. (2014) Patient Reports of Health Outcome for Adults Living with Sickle Cell Disease: Development and Testing of the ASCQ-Me Item Banks. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25146160 Knott, L. (2017). Sickle Cell Disease: Sickle Cell Anemia. Retrieved from https://patient.info/health/sickle-cell-disease-sickle-cell-anaemia Mayo Clinic. (2018). Sickle Cell Anemia. Retrieved from https://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/diagnosis-treatment/drc20355882 Miller, R. E. (2018). Sickle Cell Disease. Retrieved from https://kidshealth.org/en/teens/sickle-cell-anemia.html Otis W. Brawley, MD; Llewellyn J. Cornelius, PhD, LCSW; Linda R. Edwards, MD; Vanessa Northington Gamble, MD, PhD; Bettye L. Green, RN; Charles Inturrisi, PhD; Andra H. James, MD, MPH; Danielle Laraque, MD; Magda Mendez, MD; Carolyn J. Montoya, RN, MSN, CPNP; Brad H. Pollock, MPH, PhD; Lawrence Robinson, MD, MPH; Aaron P. Scholnik, MD; Melissa Schori, MD, MBA. (2008). National Institutes of Health Consensus Development Conference Statement: Hydroxyurea Treatment for Sickle Cell Disease. Retrieved from http://annals.org/aim/fullarticle/668699/national-institutes-health-consensus-development-conference-statement- hydroxyureatreatment-sickle Pfizer Medical Team. (2014). Managing Sickle Cell Disease as an Adult. Retrieved from https://www.gethealthystayhealthy.com. Primary Psychiatry. (2008). Psychiatric Issues in Adults with Sickle Cell Disease. Retrieved from http://primarypsychiatry.com/psychiatricissues-in-adults-with-sickle-cell-disease/ Rettner, R. (2010). Adults Struggle With What Used to Be Child’s Blood Disorder. Retrieved from https://www.livescience.com/6815- adultsstruggle-child-blood-disorder.html Sandwell and West Birmingham Hospitals. (2014). Employment and Sickle Cell Disease. Retrieved from http://www.swbh.nhs.uk/wpcontent/uploads/2012/07/Employment-and-sickle-cell-disease-ML4367.pdf Santos, M., Travi, D., Ribeiro, C., Pianca, T., Saccilotto, I., Silla, L. & Picon, P. (2017). Pain Management and Substance Abuse in Sickle Cell Disease Patients. International Journal of Technology Assessment in Healthcare, 33, 72-73. DOI:10.1017/S0266462317002057 Singh, R., Jordan, R. & Hanlon, C. (2014). Economic Impact of Sickle Cell Hospitalization. American Society of Hematology Blood Journal. Retrieved from http://www.bloodjournal.org/content/124/21/5971?sso-checked=true Tanyi, R.A. (2003). Sickle Cell Disease: Health Promotion and Maintenance and the Role of Primary Care Nurse Practitioners. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/14560435 Uzoma, A. & Burnett, A. (2015). Sickle Cell Men Are Five Times More Likely to Develop ED with Recurrent Ischemic Priapism. Retrieved from http://www.issm.info/news/sex-health-headlines/sickle-cell-men-are-five-times-more-likely-to-develop-ed-with-recurrent-isc/
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