Please respond to posts as if it were me. 

****For EACH POST ****

-150 words min, 

-1 scholarly article min (no older than 5 years), 

-APA format

Post 1 

Etiology

        Sickle cell anemia (SCA) is an inherited genetic abnormality of the oxygen-carrying protein found in red blood cells called hemoglobin S and is characterized by crescent-shaped (sickle) red blood cells and chronic anemia caused by excessive destruction of the abnormal red blood cells. Sickle cell anemia and the term sickle cell disease (SCD) are often used interchangeably; however, SCD is an umbrella term while SCA is one of 3 main genotypes (Foster & Ellis, 2018).  SCA is usually diagnosed within the first 2 years of life.  Mennella and Parks-Chapman (2018) state that SCA and sickle cell trait occur primarily in persons who are of African descent, persons with Mediterranean, Middle Eastern, Caribbean, and Asian Indian ancestry can have SCA. 

Pathophysiology

        In SCA, the red blood cells contain an abnormal form of hemoglobin called hemoglobin S.  When red blood cells contain a large amount of hemoglobin S, these red blood cells can become deformed into a “sickle” shape and are less flexible and become more prevalent when individuals have infections or decreased levels of oxygen in the blood.  The sickle cells are brittle and break apart easily.  Because the sickle cells are stiff, they have difficulty traveling through the smallest blood vessels which are called the capillaries, thus blocking blood flow and reducing oxygen supply to tissues in areas where these tiny vessels are blocked.  This blockage of blood flow can cause pain and, over time, cause damage organs such as the spleen, kidneys, brain, bones, and other organs as well as causing renal failure and heart failure.

Hallmark Signs

        Although there is no hallmark sign for an individual with SCA, the symptoms they tend to experience are generally fatigue or feeling weak.  Some individuals can even have jaundiced eyes.  The hallmark symptoms for an individual undergoing a sickle cell crisis include severe bone pain, chest pain, fever, and shortness of breath.  Some common lab results would reveal a low hemoglobin and an elevated white blood cell count, platelet count, and reticulocyte count.

Complications

        Potential complications of SCA include ischemic cerebrovascular accident, vaso-occlusion of the pulmonary vasculature, pneumonia, splenic sequestration crisis, severe infection resulting from impaired splenic function, renal dysfunction, chest pain syndrome, enlarged heart, osteomyelitis, retinopathy, blindness, transfusion-related illness due to low hemoglobin, gallstones, chronic pain, enlarged liver, bloodstream infection and aplastic crisis.

Patient Teaching

        Because there is no cure for SCA, supportive treatment is the only therapy available.  I would educate the patient to refrain from flying at high altitudes, prevent infection such as proper handwashing techniques and receiving necessary vaccinations, maintain hydration, and avoid extreme temperature fluctuations as these actions can help prevent a sickle cell crisis.  I would stress to the patient to adhere to his or her prescribed medications as indicated.  In terms of diet, I would advise the individual with SCA to consume a diet high in calories with special attention to protein, minerals such as zinc, copper, folate, and vitamins A, C, E all while spaced out into smaller, frequent meals.

Post 2 

Sickle cell disease is a group of disorders of which sickle cell anemia is the most severe. Sickle cell anemia is an autosomal recessive disorder that is caused due to a genetic mutation where the amino acid valine replaces glutamic acid to cause an abnormal form of hemoglobin within the red blood cells. “The resulting substitution of the hydrophilic amino acid glutamic acid at the sixth position by the hydrophobic amino acid valine leads to the production of hemoglobin S (HbS)” (Wun & Brunson, 2016, p. 640). When deoxygenation and dehydration occur, the red blood cell changes its shape into an elongated crescent (sickle) shape which can lead to a variety of consequences (McCance et al., 2013). Vascular occlusion, organ infarction, and pain are among the complications caused by this disorder. According to McCance et al. (2013) “sickling is an occasional, intermittent phenomenon” (p. 1065) and can be triggered by hypoxemia, a decreased pH, an increase in plasma osmolality, a decrease in plasma volume, or a low temperature. If the sickled red blood cells are not reoxygenated and rehydrated appropriately, irreversible plasma membrane damage may occur which leads to irreversible sickling.

Clinical manifestations of sickle cell anemia include the typical signs of hemolytic anemia – “pallor, fatigue, jaundice, and irritability” (McCance et al., 2013, p. 1066) and are sometimes accompanied by an acute manifestation or crises. There are four types of crises that can be triggered by extensive sickling: vaso-occlusive crisis, aplastic crisis, sequestration crisis, or hyperhemolytic crisis (McCance et al., 2013). Vaso-occlusive crisis is when sickling occurs in microcirculation and obstructs blood flow, causing vasospasm, and can lead to painful swelling of the hands and feet, priapism, severe abdominal pain, and even stroke (McCance et al., 2013). Aplastic crisis typically occurs as a result of a viral infection. Parvovirus B19 is a virus that almost always causes a person with sickle cell anemia to go into an aplastic crisis and causes the production of red blood cells to be shut down temporarily, which leads to a severe hemoglobin drop. Sequestration crisis occurs when blood becomes pooled in the liver/spleen and can lead to death if not treated with hydration and a blood transfusion. Treatment for recurrences of this crisis is the removal of the spleen after the age of 5. Hyperhemolytic crisis is characterized by red blood cell destruction at an accelerated rate, and symptoms include anemia, jaundice, and reticulocytosis.

Supportive care, which is aimed at the avoidance of these crises, is one of the key factors in the treatment and management of sickle cell disease. “Crises can be prevented by avoiding fever, infection, acidosis, dehydration, constricting clothes, and exposure to cold” (McCance et al., 2013, p. 1068). Additionally, it is recommended that all routine childhood immunizations, along with the pneumococcal and meningococcal vaccine series, and an annual influenza vaccine be given to all patients with a sickle cell disease.

For this patient, it is important to ensure that she understands the severity of her disease and how to avoid going into a sickle cell crisis, as well as the potentially life-threatening consequences if she’s not careful.

 

Refer back to the interview and evaluation you conducted in the Topic 2 Family Health Assessment assignment. Identify the social determinates of health (SDOH) contributing to the family’s health status. In a 750-1,000-word paper, create a plan of action to incorporate health promotion strategies for this family. Include the following:

1. Describe the SDOH that affect the family health status. What is the impact of these SDOH on the family? Discuss why these factors are prevalent for this family.
2. Based on the information gathered through the family health assessment, recommend age-appropriate screenings for each family member. Provide support and rationale for your suggestions. 
3. Choose a health model to assist in creating a plan of action. Describe the model selected. Discuss the reasons why this health model is the best choice for this family. Provide rationale for your reasoning.
4. Using the model, outline the steps for a family-centered health promotion. Include strategies for communication.

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.

Locate a job posting that would interest you after graduation (Medical Assistant, focusing in phlebotomy) one where the employer is identified rather than an anonymous posting or staffing agency opening. There is no min or max length for the paper to be written.

Watch the following video to assist you with completing the assignment: 7 Tips for Researching Companies. (3:38)

For the assignment:

1. Provide      the job title, job description, and URL for this job posting.
2. Discuss      what aspects of the position interest you.
3. Discuss      why you are qualified.
4. Share      something from the research you did about the company’s history and goals.
5. Share      something from the research you did on the industry the company is in.
6. Explain      why this is an industry you want to be in and why is this company      somewhere you would like to work.
7. List      the technical/hard skills required for this specific position.
8. Explain      how your education, externship(s), and previous work experience help you      to meet these requirements.
9. Identify      the soft skills that would be desirable for this position.
10. Give      examples of situations where you used these skills.

1500-2000 words APA style, 3-4 references, in-text citations  

The topics for this unit are finance, human resources, performance improvement, and technology – the business of healthcare. 

You have been asked to speak to a group of students in nursing and other healthcare professions. 

You are assigned to talk about the importance of finance, human resources, performance improvement, and technology in healthcare organizations.

1. Does your organization have a competitive advantage?

2. If so, explore how and why this is a competitive advantage.

3. If not, do you see an area that could be developed as a competitive advantage?

4. If you were in charge, what would you do moving forward to build/create a competitive advantage for our organization?

 

Medical records belong to the patient and the healthcare facility in which they were created. This is why patients are allowed a copy of their medical record, but not the original document.

Please read the following article from American Health Information Management Association (AHIMA) regarding the retention and destruction of health information, http://library.ahima.org/doc?oid=300217#.XXbKHzZKiM8, and then discuss:

• What are the different types of healthcare records and where are they often stored?
• What is considered an active record and an inactive record?
• What is the difference between purging records and destroying records?
• When are healthcare records allowed to be destroyed and what are some of the reason’s records would be destroyed?