Miss Sarah Smith Explained for Students (Easy Guide)
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Original Question
Miss Sarah Smith, 28-year-old female, Afro-Caribbean, presented to the emergency department with severe pain in her lower back, arms and chest. Here pain score upon arrival is 9/10 on the pain numerical scale. She reports that the pain started suddenly a week ago and has progressively worsened. She has been reluctant to seek medical support as had negative experiences in the past where her symptoms were overlooked, and her pain management was not optimal. She also mentions that she is currently feeling very fatigued. In the last few days she has become significantly short of breath especially on exertion. Her mucus membranes are pale. A provisional diagnosis of sickle cell crisis was made. Upon arrival to A&E her observations are: Blood Pressure: 100/60 mmHg Heart Rate: 110 beats per minute Respiratory Rate: 28 breaths per minute Oxygen Saturation: 88% on room air Temperature of 38.5°C Laboratory Results Haemoglobin (Hb): 7.5 g/dL (normal range: 12-15 g/dL) White Blood Cell Count (WBC): 15 x 10^9/L (normal range: 4-11 x 10^9/L) C-reactive Protein (CRP): 50 mg/L (normal range: <5 mg/L) The patient's past medical history is: Sickle cell anaemia (HbSS) Frequent admissions to the hospital due to Sickle cell crisis Pneumonia and acute chest crisis Social/psychological Background: Sarah is an office administrator and has been under significant stress at work lately due to a recent increase in workload and tight deadlines. She is also experiencing financial difficulties, which have been exacerbated by her frequent hospital visits and inability to work during pain crises. Sarah also has been going through a difficult period in her relationship, adding to her emotional stress. LO 1: Critically evaluate key pathophysiological and pathopsychological concepts underpinning physical and mental health conditions and select appropriate evidence-based interventions. LO 2: Critically analyse scientific evidence to evaluate acute and long-term disease progression in relation to morbidity and mortality with reference to associated anatomy and physiology. LO 4: Critically reflect on and evaluate ethical concerns including the contribution of genetics in disease aetiology. LO 5: Critically review the concept of stress and vulnerability to explain experiences of ill health and stigma LO 6: Demonstrate a deep understanding of health across the lifespan (including end of life) impact to family, and wider social networks related to nursing priorities.
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