(^198) Medical-Surgical Nursing Demystified
- Elevated WBCs.
- Increased reticulocytes.
- Presence of Howell-Jolly bodies and target cells.
- Sickle cells appear in blood smear.
- Indirect bilirubin level elevated.
- Hemoglobin electrophoresis shows majority hemoglobin S (80 to 98 percent).
TREATMENT
During acute episodes pain control, hydration, and oxygenation are the focus of
treatment. The underlying cause that sent the patient into crisis will also need to be
treated concurrently.- Administer analgesics to alleviate the pain associated with the vaso-occlusive
process:- narcotic pain control necessary when pain is severe
- Warm compresses on joint.
- Blood transfusion of packed RBC when anemia indicates.
- Supplemental oxygen if hypoxic.
- Adequate hydration, using IV fluids.
- Treat infections.
NURSING DIAGNOSES
- Fatigue
- Acute pain
- Impaired gas exchange
NURSING INTERVENTION
- Increase fluid intake.
- Monitor IV fluids.
- Monitor pain control.