Sickle Cell Anemia Question

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Hey guys. So I am doing a Sickle Cell Anemia research paper/case study and I seem to be stuck on this one question. "Discuss how these lab results are consistent with patients who have SCA". The lab results are as follows:

white blood cell count (WBC) 18 x 109/L (higher than norms)

red blood cell count (RBC) 3x1012/L (lower than norms)

hemoglobin (Hgb) 75 g/L (lower than norms)

hematocrit (Hct) 0.218 (lower than norms)

reticulocyte count 0.23 (lower than norms)

ABG'S

pH 7.54 (alkalosis)

PaCO2 32 (lower than norms)

HCO3 22 (in range)

PaO2 87 (in range, but on the low end)

I understand why the RBC, Hgb, Hct, retic count, and WBC count are outside of norms considering the diagnosis, but I don't understand why the ABG's are affected. All thoughts are appreciated!

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If I can answer this question, everything else will make sense: why do sickle cell anemia patients have hypocapnia?

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Specializes in Adult Internal Medicine.

Do sickled cells carry oxygen as well as a RBC with normal morphology?

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That's an acute respiratory alkalosis you have there.*

* huge hint. Does pain make somebody hyperventilate?

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This is the conclusion i am trying to make: Because the red blood cells take on a sickle shape and harden, they cannot easily pass through capillaries or other small vessels and can cause vascular occlusion, leading to acute or chronic tissue injury. The red blood cells cannot effectively carry out internal gas exchange which has lead to local hypoxia and hypocapnia. For the same reason, although her PaO2 is in range, it is still low. In an attempt to compensate, her respiratory rate has increased to 25 beats per minute.

Is this correct?

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That's an acute respiratory alkalosis you have there.*

* huge hint. Does pain make somebody hyperventilate?

I'm so happy I correctly interpreted that ABG!

14.5 more weeks until graduation! Woo! NCLEX time.

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Specializes in Adult Internal Medicine.
This is the conclusion i am trying to make: Because the red blood cells take on a sickle shape and harden they cannot easily pass through capillaries or other small vessels and can cause vascular occlusion, leading to acute or chronic tissue injury. The red blood cells cannot effectively carry out internal gas exchange which has lead to local hypoxia and hypocapnia. For the same reason, although her PaO[sUB']2[/sUB] is in range, it is still low. In an attempt to compensate, her respiratory rate has increased to 25 beats per minute. Is this correct?

You are on the right track there! What do the ABGs tell you (someone mentioned in a previous post, but make sure you understand it)?

If a patient is in pain, or they have cells that are struggling to carry oxygen, they respond by doing what?

What does the HCO3 tell you?

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In the case study, it does say that she has a pain score of 8/10. And I understand how that would relate to her tachypnea. Lastly, her HCO3 level is in normal range

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Specializes in Adult Internal Medicine.
In the case study it does say that she has a pain score of 8/10. And I understand how that would relate to her tachypnea. Lastly, her HCO3 level is in normal range[/quote']

Very good.

And what does a normal HCO3 tell you?

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Well her HCO3 level is not exactly normal so to say, it is on the low end (normal range is 21-28). Shouldn't the HCO3 levels be high instead in an attempt to compensate and bring the pH back down?

Carbonic acid (H2CO3) should be dissociating in the blood to release more H+ and HCO3 into the blood to lower the pH back down (yet the HCO3 levels is not as high as it should be?)

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Somebody please clarify this for me :$

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Somebody please clarify this for me :$

This is so interesting :p I hope someone can clarify it cus now I'm wondering too... I keep refreshing the page LOL.

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