Nursing 209

N209: Reproductive Health Study Guide o HbSC: The milder form of SCD; child inherits one sickle cell gene from one parent, and an abnormal hemoglobin gene called “C” from the other parent o HbS beta thalassemia: The child inherits one sickle cell gene from one parent, and one gene for beta thalassemia from the other parent  Can be beta 0-thalassemia, the more severe form of SCD , or beta +-thalassemia, the milder form of SCD • Diagnosis: o Screening is performed prenatally via hemoglobin electrophoresis; if mother is positive for SCT, the father of the baby should be tested as well and referred to genetic counseling as indicated o Diagnosis is confirmed prenatally via amniocentesis or CVS o After birth, diagnosis is made via a blood test from the infant’s heel to check for presence of Hemoglobin S • Complications: o Pain, anemia, infection, acute chest syndrome (similar to pneumonia), splenic sequestration (enlargement), vision loss, leg ulcers, and stoke o Sickle cell crisis: Pain resulting from occlusion of small blood vessels • Treatment: o There is no best treatment for SCD o Treatment is based on symptoms; the only cure is bone marrow or stem cell transplant o Should be encouraged to prevent sickle cell crisis with adequate hydration, avoidance of temperature extremes, high altitudes, or low oxygen levels 6.8 The Nursing Process Assessment • Obtain patient’s health history, as well as family history (especially regarding any genetic factors). • Assess patient’s susceptibility to congenital disorders (illegal drugs, radiation, and infectious agent exposure prenatally). • Review laboratory and diagnostic data for any abnormal findings. Analysis/Diagnosis • Identify nursing diagnosis pertaining to patient/fetal risk. Planning • Establish expected outcomes for care related to health promotion, maintenance, and restoration to allow for a healthy pregnancy.

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