Registered Nurse

Sickle Cell Anemia

INTRODUCTION: “Pain” sudden or chronic, lasting from a few hours to a few days; from a few weeks to a few months evolving from an adhesive substance in red blood cells. The “Pain” is inherited by an retriction blood flow through the body do to an abnormality in the cells. “Sickle Cell Anemia” a chronic illness discovered in 1910 by an American physician named James Bryan Herrick. Sickle Cell is more that just pain; it is a disease that is affected by abnormal blood cells that has an adhesive formation causing the natural flow to be compromised. As a result, these abnormal cells become fixed in the blood stream and not flowing to major body organs causing extreme pain and even a stroke. Why is this process painful? Have sickle cell patient become tolerant to pain or is it because some of them handle self-care management? For many years there has been a link between Sickle Cell Anemia and Pain caused by the stickiness of the blood cells. When this occurs, it decreases normal blood flow to the major organs causing strokes.(citation ). Sickle cell anemia is most common in people whose families come from Africa, South or Central America (especially Panama), Caribbean islands, Mediterranean countries (such as Turkey, Greece, and Italy), India, and Saudi Arabia. In the United States, it's estimated that sickle cell anemia affects 70,000–100,000 people, mainly African Americans. The disease occurs in about 1 out of every 500 African American births. Sickle cell anemia also affects Hispanic Americans. The disease occurs in more than 1 out of every 36,000 Hispanic American births (Citation).More than 2 million Americans have sickle cell trait. The condition occurs in about 1 in 12 African Americans. In people with sickle cell disease, approximately 50% do not survive beyond age 20 years, and most people do not live past 50 years of age (Citation)
MY QUESTION: How can pain be prevented in sickle cell patients? OR: In what ways do hydration, antibiotics and pain medication influence the blood?
The purpose of this paper is to determine the underlying cause of pain in sickle cell patients. My efforts are focus on examining the adhesiveness of their abnormal blood cells and how to prevent it, if possible. With this study, answers to stroke prevention in sickle cell patients may also be discovered.
As a registered nurse living with the sickle cell trait and having lost two family members (ages 7 and 29) to this disease, I find nursing research to be an added treasure to discovering the cause of their pain.
Literature Search A systematic review of existing research and literature on the cause of pain in sickle cell patients were conducted in the databases of CIHAUL and Pub Med. The term, Sickle Cell Anemia searched independently yielded 2,773 results. However with limiters, such as Full Text, Research Article and Journal Subset: Nursing yield only 40 results. Key words, Pain, Stroke, Gene, Prevention, Management and prognosis yield approximately 2,000 results. However, Key terms such as adhesive and stickiness no results were found. Criteria use for inclusion of this study were nursing articles and journals from 1977-2013, full text with abstracts, adult and children. Exclusion criteria consist of publication prior to 1977, asymptomatic sickle cell patients, non-nursing journals and articles and non-African Americans (I was focusing on the African population or should I make it broad to all affect nationalities?)
Continuous research efforts have been employed on how to prevent and decrease pain in sickle cell patients. These include adequate hydration, Hydrourea therapy, exercise, avoidance of stress prophylactic penicillin and pain medication specifically for the patient. Author (2005) advice the patient to take steps to stay healthy, including getting adequate rest, eating a balanced diet, and protecting against infection. Tell him, too, to avoid smoking and caffeine. Infants and children with sickle cell disease need regular childhood vaccinations, and both children and adults should have a yearly flu shot and be immunized against pneumonia. There was a pilot study perform by several members of the institututional review board from Yale and Howard University. This study bought two achievable goals in helping patient with sickle cell. First, they evaluate the perception of sickle cell patient as they handle the chronic pain of their disease. Secondly, they were able to analysis the data given develop interventions that will help decrease sickle cell crisis. The participants were chosen between February 2005 and January 2006 from two urban, outpatient sickle cell clinics in the U.S. The criteria for participating were Sickle Cell Patients forty five years and older and able to understand English. With this study, Lauderdale and Jernerette (2008) discovered that the participant’s first SCD crisis occurred at about seven years of age and they were hospitalized three times per year due to SCD. As Nurses, intervention such as educating the patient or family members on how to prevent or monitor the pain can decrease hospital and emergency room visits.

In this study a exploratory-decriptive study will be conducted in attempting to discover ways to decrease pain in sickle cell patients.