Sickle Cell
SKINNY Reasoning
Part I: Recognizing RELEVANT Clinical Data
History of Present Problem: Anthony Perkins is a 15–year–old African American male who was at a medically monitored summer camp and participated in several sports activities when the outside temperature was greater than 90 degrees. He began having pain in his knees and was evaluated by the camp nurse. After evaluation, he was transported to his primary care provider and evaluated. Anthony was transferred as a direct admit to the pediatric floor of the community hospital where you are the
primary nurse responsible for his care. He weighs 154 lbs or 70 kg.
Personal/Social History: Anthony was diagnosed with sickle cell anemia at birth during a routine newborn screening. He was a term newborn with normal childhood illnesses. He has been hospitalized with pneumonia four times – at age 8, 9, 11, and 14. He is up to date on childhood immunizations, and recently received his pneumococcal and influenza vaccines.
Anthony has had multiple hospitalizations for sickle cell crises and transfusions. He lives with his parents and two siblings, a younger brother (9 years old), and sister (4 years old). His family lives in a three–bedroom, two–bath home.
Anthony’s father is an accountant and the sole financial provider of the family. Anthony’s mom stays home, raising the children. The family is covered by a private medical insurance PPO through Anthony’s father’s employer.
Personal/Social History:
What data from the histories are important and RELEVANT and have clinical significance for the nurse?
What data from the histories are important and RELEVANT and have clinical significance for the nurse?