top-rated free essay

Module Title: Theoretical Concepts of Health and Disease

By marciahylton May 05, 2013 796 Words
MODULE TITLE: Theoretical Concepts of Health and Disease

Marcia Hylton
Introduction
Sickle cell disease is an umbrella term used to describe a group of inherited disorders of the haemoglobin known as haemoglobinopathies and includes Sickle Cell Anaemia, which generally is the most severe form. It is found in people of African and Caribbean origin and to a lesser extent in people of Mediterranean, Asian and Middle Eastern origin. People of these origins live all over the world, therefore the Sickle Cell disorder is of international significance, (Pembrey, 1994). Sickle Cell Disorder is the most common and fastest growing genetic disorder in England and now affects 15,000 people in the UK, and one in 2,400 babies, with prevalence growing (NHS, 2006). The most common forms of sickle cell disease (SCD) are sickle Haemoglobin C (Hb SC), Sickle Beta Thalassaemia (Hb S BThal), and Sickle Cell Anaemia (Hb SS).The most common and most severe form is Sickle Cell Anaemia (Hb SS). There is no cure. This assignment will briefly describe a case study with discussion of a patient admitted to hospital with one of the complications of Sickle Cell Anaemia, namely Acute Chest Syndrome. This assignment will further discuss the pathophysiology and management of Acute Chest syndrome (ACS). Case Study

A 19 year old African Caribbean male presented to the Emergency Admissions Unit (EAU) with severe pleuritic chest pain. The pain had begun three hours previously with coughing, fever and chills for the previous 24 hours. This was his first hospital admission this year with a sickle cell crisis, although he stated that he was was unwell two weeks previously. On examination, the patient was found to be dyspnoeic and pyrexial (39º C), tachycardic (Pulse 110), hypertensive (BP 145/90), with oxygen saturation at 90%. Bronchial breath sounds with inspiratory crackles were heard on inspiration. Assessment of the patient suggested chest infection leading to Acute Chest Syndrome (ACS). The plan for the patient was to give pain relief using patient controlled analgesia morphine infusion and oxygen therapy, along with bronchial dilators. Full blood count and blood cultures, arterial blood gases, also cross matched blood for possible blood transfusion. A chest x-ray and intravenous fluids to rehydrate the patient were initiated, along with oxygen therapy. Broad spectrum antibiotics were to be given. The patient was to be admitted to the haematology ward for monitoring.

Discussion

The sickle cell gene is transmitted by recessive inheritance and can manifest as trait (Heterozygote Hb AS) or sickle cell anaemia (Homozygote Hb SS). According to Porth (2005), individuals who are heterozygous only have approximately 40% of sickle haemoglobin (HbS) and generally have no symptoms other than very mild anaemia, whereas the homozygous individual has 80-90% of sickle haemoglobin. Porth further asserts that variations in proportions exist and the concentration of HbS correlates with risk for ‘sickling’. This would account for the variations in the severity of the condition noted in individuals.

It is recognised that half of individuals with Sickle cell Anaemia will develop Acute chest Syndrome (ACS) at least once in their lifetime (Mak, Davies 2003), (Gladwin, Rodgers, 2000). Furthermore, it is the second most common reason for admission to hospital for people with sickle cell anaemia after the vaso-occlusive crisis. It also accounts for approximately 25% of premature deaths amongst sufferers (Gladwin, Rodgers, 2000).

ACS is a form of lung injury that can develop into acute respiratory distress syndrome rapidly. It is an amalgamation of signs and symptoms that include pain, fever, tachypnoea, leukocytosis and pulmonary infiltrates. Recurrent exacerbations of ACS may result in pulmonary fibrosis, pulmonary hypertension and cor pulmonale (Hajeri et al, 2008). It is a medical emergency and as such should be treated immediately. Treatment with transfusions and bronchodilators improves oxygenation. The causes, clinical presentation and possible outcomes of ACS has been well evidenced (Mak, Davies, 2003). However, management of this complication of sickle cell anaemia is less well known (Schnog et al, 2004) and therefore has implications for the management and outcomes for ACS, bearing in mind that it is the leading cause of death in patients with sickle cell anaemia.

Pathophysiology
Sickle cell disorder is caused by autosomal recessive defects of the red blood cells and can manifest as trait (heterozygous)with one HbS gene, or as sickle cell anaemia, with two HbS genes. There are over 600 varieties of haemoglobinopathies and they can affect either the structure of the beta-globin chain (Sickle cell disorders), or reduce the quantity of either alpha or beta haemoglobin chains (Thalassaemias). The normal adult haemoglobin (HbA) is the most predominant haemoglobin type (97%), and consists of two alpha and two beta globin chains. These chains are wrapped around a haem (iron containing) molecule. Other haemoglobins are HbA2 (2-3%) and foetal haemoglobin (HbF

Cite This Document

Related Documents

  • health and disease

    ... Defence against Disease and the Immune System In this essay I have distinguished clearly between active/ passive, natural/artificial immunity and described some methods of vaccine production. I have critically compared the effectiveness of the smallpox vaccination programme with programmes aimed at control of measles, polio, influe...

    Read More
  • title

    ...Biomass energy is the energy which is contained inside plants and animals. This can include organic matter of all kinds: plants, animals, or waste products from organic sources. These sorts of energy sources are known as biofuels and typically include wood chips, rotted trees, manure, sewage, mulch, and tree components. Chlorophyll present i...

    Read More
  • CONCEPTS OF HEALTH

    ... CONCEPTS OF HEALTH Introduction  This essay will firstly discuss what health is as a broad concept, look at the differences of health looking at the negative and positive aspects and how health can be socially constructed. Defining what is meant by holistic health and what effects promoting health can help reduce individuals getting ill by...

    Read More
  • Concept in Health

    ...| CONCEPTS IN HEALTHCARE ORGANIZATIONS | | 4/15/2013 | Step 1: Put the following steps in the order of a routine patient care flow, from the beginning through the end of the patient encounter. 1. Call in to schedule appointment 2. Signs in at reception desk 3. New patient paperwork is signed and returned to fro...

    Read More
  • Theoretical Concepts Of ELH

    ...Theoretical concepts of ELH 1. Development 2. Evolution  3. Change 4. Mechanism of a change 5. Diachrony  6. Synchrony 7. Statics 8. Dynamics 9. Language space 10. Linguistic situation DEVELOPMENT 1) The act of developing or the state of being developed, as: The application of techniques or techno...

    Read More
  • understanding of the theoretical concept

    ...In this essay, my objective is to demonstrate my understanding of the theoretical concepts and techniques used in hypnotic inductions and to discuss my reasons for believing that it is best that an induction is personalised as well as the reasons why they may not always be the best strategy. Research shows that words make up 7% of our com...

    Read More
  • P1 explain the concepts associated with nutritional health

    ... P1- Explain the concepts associated with nutritional health Food is defined as any nutritional substance that humans or animals eat or drink in order to maintain healthy life and growth. There are many different types of food and drink that both animals and humans consume. The food we eat determines the lifestyle we have. A diet is not jus...

    Read More
  • Endothelium in Health and Disease

    ...inactivation of the cAMP and thus induces smooth muscle constriction. To overcome the effect caused by adrenoreceptor agonists higher concentrations of nitroprusside is required. (Vascular Rings, 2010) Hence, by removing an endothelium the effect of nitroprusside is not inhibited and evokes a larger response at low concentrations. ...

    Read More

Discover the Best Free Essays on StudyMode

Conquer writer's block once and for all.

High Quality Essays

Our library contains thousands of carefully selected free research papers and essays.

Popular Topics

No matter the topic you're researching, chances are we have it covered.