Case study : A 17-year-old African American female from the inner city complains of severe chest and abdominal pain

A 17-year-old African American female from the inner city complains of severe chest and abdominal pain

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A 17-year-old African-American female from the inner city is experiencing severe chest and abdominal pain. The attending physician conducts an EKG, a chest x-ray, and an abdominal and chest clinical examination and discovers nothing. He sends her home, assuming she is looking for drugs. She returns to the ER four hours later, and you now see the patient. She explains that she was running track at school this afternoon and that despite the heat (100 degrees Fahrenheit), she kept going. Following that, she begins to experience severe pain in her chest and abdomen. Her eyes are jaundiced, her blood pressure is 98/50, her pulse is 112, her temperature is 99.9 degrees Fahrenheit, and her respiratory rate is 28. The pain appears to be out of proportion with the physical findings. During a medical history review, she informs the provider that she has a history of sickle cell anemia. At this point, it has been determined that she is suffering from a sickle cell crisis.

What is the etiology of sickle cell anemia?
Describe in detail the pathophysiological process of sickle cell anemia.
Identify hallmark signs identified from the physical exam and symptoms.
Describe the pathophysiology of complications of sickle cell anemia.
What teaching related to her diagnosis would you provide?
In addition to the textbook, utilize at least one peer-reviewed, evidence based resource to develop your post.

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Sickle cell disease is “a group of disorders characterized by the presence of an abnormal form of hemoglobin—hemoglobin S (HbS)—within the erythrocytes” (McCance, Huether, Brashers, & Rote, 2013, p. 1063). It is an inherited disease from at least one of the

A 17-year-old African American female from the inner city complains of severe chest and abdominal pain
A 17-year-old African American female from the inner city complains of severe chest and abdominal pain

parents. Sickle cell disease is a lifelong illness, but it can be managed. There are different types of sickle cell disease including sickle cell anemia, sickle cell-thalassemia disease, and sick cell-HbC disease. There is even the sickle cell trait where a person can be a carrier, having inherited the HB S from one parent. However, there are rarely clinical issue with those who are just carriers. Sickle cell anemia is a normocytic-normochormic anemia, or NNA, meaning that it is “characterized by erythrocytes that are relatively normal in size and hemoglobin content but insuffcient in number” (McCance, Huether, Brashers, & Rote, 2013, p. 993).

There are five groups of NNAs including the hereditary hemolytic type that sickle cell anemia is because of the destruction by eryptosis, or the destruction erythrocytes through cell shrinkage, membrane blebbing, or activation of proteas (McCance, Huether, Brashers, & Rote, 2013, p. 993). Sickle cell anemia is the most common sickle cell disease and the most severe (NHBLI, 2014). It is estimated that there are between 70,000 and 100,000 Americans who suffer from sickle cell anemia with those affected most being of African ancestry. While sickle cell has a high rate of morbidity, more than 90% of diagnosed children do survive into adulthood, however, their lifespan is diminished (NHBLI, 2014). Sickle cell disease is screened in every newborn born in a hospital in the United States. This is done through a simple blood test that checks the hemoglobin in the body.

Chest Pain: Causes and Associated Symptoms

Chest pain can be caused by a number of things, ranging from a moderate case of heartburn to a heart attack.
Due to the wide variety of severity of chest pain, it is critical to have a thorough grasp of what various chest pain symptoms signify and how to treat them quickly.

Chest pain can be caused by four different things: a heart problem, a stomach problem, a lung-related issue, or a muscle-and-bone problem.
Heart-related problems, such as angina or a heart attack, are the most dangerous, but lung-related problems, such as a pulmonary embolism, can also be fatal.

Any muscle or intestinal disorders, however, might be serious, and every case of chest pain should be treated.

While the reason of chest pain may be evident in certain circumstances, such as a physical injury or strained muscles, determining the exact origin of other types of chest pain can be difficult.
It’s critical to understand the symptoms and what they signify in order to correctly analyze the source and severity of your chest discomfort.
The following are the most prevalent symptoms associated with chest pain:

In the chest, there is a feeling of pressure or tightness.

Breathing problems

Weakness or dizziness

Vomiting and nausea