JOURNAL 7

Practicum – Journal Entry
Author’s Name
Institutional Affiliation

Practicum – Journal Entry
During my practicum, I happened to have encountered a five-year-old child with a genetic disorder commonly known as sickle cell anemia. By design, Sickle cell anemia is a condition in which red blood cells (or erythrocytes) become rigid, sticky, and irregularly shaped such that they cannot flow easily through blood vessels (Pedram et al., 2012). The medical history of the Child showed that she was given birth to earlier than the normal gestation period: a preterm baby. She was delivered through cesarean as a result of her mother’s maternal distress. Physical examination tested positive for fever with an extreme body temperature of 38.6°C. She had a pulse rate of 109 per minute plus a blood pressure of 9050 mmHg.
Notably, signs of the child’s’ wrist and thumbs were positive, toes were normal, and the fingers were abnormally long. The abdominal examination depicted the presence of hepatosplenomegaly. The respiratory examination also showed the presence of Rales and rhonchi, signaling breathing difficulties (Stanford Children’s Health, 2018). Upon carrying out the chest radiograph, it was shown that she had bilateral haziness. However, her urinalysis and renal function were revealed to be normal. Her hemoglobin was low to approximately 4.5 gm/dL.
My “aha” moment during the examination of the patient can be attributed to the fact that the child had dactylitis on her fingers showing that she had acute splenic sequestration crisis, which is the primary cause of death among kids with sickle cell anemia (Platt et al.

, 1994). Ideally, this experience did connect my classroom experience to the practical clinical setting because I have just studied acute chest syndrome and how it can be treated by employing a wide spectrum antibiotic. The experience was worth undergoing since I had to understand the unusual relationship between splenic sequestration and acute chest syndrome
References
Pedram, M., Jaseb, K., Haghi, S., & Vafaie, M. (2012). First Presentation of Sickle Cell Anemia in A 3.5-Year-Old Girl: A Case Report. Iranian Red Crescent Medical Journal, 14(3), 184.
Platt, O. S., Brambilla, D. J., Rosse, W. F., Milner, P. F., Castro, O., Steinberg, M. H., & Klug, P. P. (1994). Mortality in sickle cell disease–life expectancy and risk factors for early death. New England Journal of Medicine, 330(23), 1639-1644.
Stanford Children’s Health. (2018). Sickle Cell Disease in Children. Retrieved July 11, 2018, from http://www.stanfordchildrens.org/en/topic/default?id=sickle-cell-disease-in-children-90-P02327