211 Sickle Cell

Which areas are at highest risk for sickle cell anemia? (select all that apply)

• Central Africa

• The Near East

• Mediterranean

• Aboriginal Indians

• Hispanics from Caribbean and Central & S. America

Answer explanation

Near East includes (Western Asia, Turkey, Syria, etc.)

True or False: Males are more prone to having sickle cell than women

• True

• False

Answer explanation

Males who have sickle cell tend to have worse complications than Females who have sickle cell.

-This is due to women producing more nitrous oxide, which relaxes blood vessels, reducing complications.

What is the lifespan of sickle cells?

• 120 days

• 80 Days

• 40 days

• 20 days

• 5 days

Answer explanation

10-20 days is the lifespan of sickle cells, compared to regular red blood cells. Regular red blood cells have a lifespan of 120 days.

True or False: People who have the sickle cell trait have two copies of the gene that causes sickle cell.

• True

• False

Answer explanation

Folks who have the sickle cell trait only have one copy of the gene; they're also called carriers.

People who are affected with sickle cell have two copies of the sickle cell gene.

A nurse has a patient with sickle cell anemia. What symptoms should they expect? (Select all that apply)

• Facial bones shrinking

• Swelling

• Frequent Infections

• Bradycardia

• Murmurs

Answer explanation

Enlargement of bones of face & skull ; not shrinkage

Pts will experience tachycardia not, bradycardia.

Other S&S:

- Fatigue & Weakness

- Pain from lack of O2

- Fever from frequent infections due to spleen infection (

Which of the following indicate a diagnosis of Sickle cell? (Select all that apply)

• HCT of 60%

• Reticular percentage of 1.4%

• Reticular absolute count of 375

• Hgb of 9.8

Answer explanation

- Low HCT & low Hgb are indicators of sickle cell

Hgb Male: 13.5-18; Hgb Female: 12-15

HCT Male: 40-54%; HCT Female: 36-46%

- High reticular values indicate sickle cell

Retic %: 0.5-1.5; Retic count: 50-100

True or false: It is goo to have a higher level of HCT & Hgb in sickle cell patients to prevent clotting.

• True

• False

Answer explanation

Lower levels of both prevent clotting.

Tries to maintain Hgb of 11 or below.

Which of the following is a cause of aplastic crisis?

• Heights

• Dehydration

• Cold temperatures

• Parvovirus

• Pooling of sickle cells in spleen

Answer explanation

3 Types of sickle cell crises:

1) Vaso-Occlusive cause: Stress, illness, heights, dehydration, cold, too much alcohol, over exercise

2) Aplastic cause: Typically viruses, but she state parvovirus in lecture (Affects teenagers 16 & under)

3) Sequestration cause: Due to pooling of sickles in spleen. Can lead to speen removal (Typically seen in kids under 5 due to size)

Which sickle cell crisis mostly affects children below 5 years old?

• Acute Vaso-Occlusive Crisis

• Aplastic Crisis

• Sequestration Crisis

Answer explanation

Aplastic affects mostly teenagers below 16.

Which of the following are complications of sickle cell?

• Pulmonaryhypotension

• CVA/Stroke

• Infection in lungs causing fever, SOB, & cough

• Renal & heart failure

• Leg ulcers

Answer explanation

Other complications not listed:

1) Anemia

2) Pulmonary Hypertension not hypotension (May be due to clustering of sickles in pulmonary artery; Once developed, it isn’t curable. Will need to be treated)

3) Acute chest syndrome - described as infection in lungs causing fever, SOB, & cough. Typically occurs after PE or blood clot

4) Heart/Renal (Overworked heart trying to push blood & overworked kidney filtering sickles)

5) Infection

6) Leg ulcers: Lack of blood flow