Homework question...

a newborn is diagnosed with sickle cell anemia. explain to the parents how the subsitution can have such a drastic effect on the structure of the protien....?

what substitution are you talking about?

johnnys body temp is spiking upward, when it reaches 104 his mother calls the pediatrician. she is advised to give him childrens asprin and sponge his body with cool water to prevent a further rise. how might a fever be detrimental to johnny's welfare...?

untreated, a fever rises. when fevers reach higher than 104 degrees patients have seizures. brain damage can occur during a seizure not to mention physical harm from the thrashing about.

mrs. gallo's physician suspects that she is showing signs of multiple sclerosis. what medical imaging technique will the physician use to see if she has it....?

a newborn is diagnosed with sickle cell anemia. explain to the parents how the substitution [of an amino acid] can have such a drastic effect on the structure of the protein....?

this question has to do with the pathophysiology of the formation of hemoglobin within erythrocytes. valine, an amino acid, replaces (is substituted for) glutamic acid, one of the amino acids required in the dna chain of hemoglobin s. the result is a sickled appearing red blood cell that contains hemoglobin which erroneously reacts to deoxygenation and dehydration by solidifying and stretching the erythrocyte (red blood cell) into an elongated sickle shape. these sickled (elongated) cells have difficulty passing through the blood vessels of the body because of their shape. they tend to become trapped and lodged in the capillaries resulting in a number of different symptoms:

• pallor
  
• pale lips, tongue, palms and nail beds
  
• fevers
  
• fatigue
  
• sleepiness with difficulty awakening
  
• jaundice
  
• hematuria (blood in the urine)
  
• pain
  
• irritability
  
• tachycardia
  
• systolic and diastolic murmurs
  
• hepatomegaly and splenomegaly
  
• life-threatening crises of four types
  • vasoocclusive (thrombotic) - clotting in blood vessels with severe abdominal and/or bone pain - strokes can occur
    
  • aplastic - profound anemia with pallor, lethargy, sleepiness, dyspnea, possible coma, decreased bone marrow activity and red blood cell hemolysis (rupture)
    
  • sequestration - blood pooling in the liver and spleen that untreated progressed to hypovolemic shock and death
    
  • hyperhemolytic - hemolysis (rupturing) of the blood cells that causes liver congestion and hepatomegaly

(references: pathophysiology: the biologic basis for disease in adults and children, third edition, by kathryn l. mccance and sue e. heuther; nurse's 5-minute clinical consult: diseases from lippincott williams & wilkins)

when you get to your nursing classes you will be expected to know the pathophysiology, like above, for all the medical conditions a patient can have. that will be part of your nursing education along with learning nursing care. you will need to learn this information in order to learn to solve problems that patients have. this is a component of what you will hear nursing students refer to as "critical thinking".