peer response: I need a response to this discussion... | Nursing

Clinical Requirement:

I need a response to this discussion post. I will post the discussion that needs a response, then I will place the rubric and instructions below:  Disscusion post: Given the information provided in the case study, I believe this individual suffers from Sickle cell disease (SCD).  According to Rare Disease Advisor, SCD is an autosomal mutation of the hemoglobin chain on chromosome 11 that causes red blood cells to be misshapen and occurs mostly in non-Hispanic Black individuals (Habet, n.d., p. 1).  I came to this conclusion after losing at the peripheral smear of the blood sample provided that showed sickled cells, target cells, and Howell-Jolly bodies which are hallmarks of sickle cell disease with splenic injury along with the patient’s complaint of severe pain with multiple episodes reported over the last year. Genetic mutations associated with SCD SCD is a genetic mutation in and of itself, however there are a few genetic mutation types of SCD.  “The most prevalent types of sickle cell disease are sickle cell anemia, sickle cell-thalassemia disease, and sickle cell-HbC disease” (Rogers, 2023, p. 997).  Each of these disorders are considered autosomal recessive disorders that affect the hemoglobin cell causing it to be mishappen. Presenting Symptoms Within the case study provided, the patient presents with complaints of severe pain that started in his legs and has gone to his back with no known trauma.  The patient reports that he has had similar episodes of the same over the past year that were associated with dehydration or infection.  These are pertinent symptoms to SCD because the “sickling process is an occasional intermittent phenomenon that can be triggered by stressors such as decreased oxygen tension of the blood, acidosis, increased plasma osmolality, decreased plasma volume, and low temperature” (Rogers, 2023, p. 997).  The sickled shape of the hemoglobin molecule causes microvascular occlusion which results in pain for the patient.  When the patient describes his previous episodes there is a stressor identified that would start the sickle cascade and then would result in pain as the sickle cells cause the microvascular occlusions. Pathophysiology of SCD As stated previously, SCD is a genetic recessive condition involving the hemoglobin molecule.  “Sickle cell disease (SCD) is caused by a mutation in the gene that encodes the beta-globin chain of the hemoglobin molecule. This mutation results in the formation of sickle hemoglobin (HbS), which has the unique feature of polymerizing on deoxygenation.1 Because of a single base-pair point mutation (GAG to GTG) in the beta-globin gene, the amino acid glutamic acid (which is hydrophilic) is replaced by valine (which is hydrophobic) at position 6 of the beta-globin molecule, resulting in the formation of HbS” (Habet, n.d., section 8). Disease and disease progression In evaluating the blood work provided for this case study there are many things that are concerning related to sickle cell disease.  The patient presents with decreased hemoglobin and hematocrit, significantly below normal levels.  This can indicate that the patient has anemia and given the peripheral smear results it can be thought that the patient may be Sickle cell anemia which is the most severe form of SCD.  He also has an elevated WBC count which may be indicative of an infection, which can be the stressor the body needs to start the sickle cell cascade that may result in the cause of the patient’s pain.  He also has an elevated bilirubin which can be indicative of liver damage.  Also, the presence of Howell-Jolly bodies in the peripheral smear is indicative of splenic damage with SCD.  With this information I would conclude that this patient has a severe form of SCD that has started to cause significant organ damage which means that the disease is progressing to cause irreversible damage to the patient's organs. References Habet, K. (n.d.). Sickle cell disease. Rare Disease Advisor. Retrieved November 26, 2025, from https://www.rarediseaseadvisor.com/hcp-resource/sickle-cell-disease-histology/Links to an external site. Rogers, J. (2023). Mccance & huether's pathophysiology the biologic basis for disease in adults and children (9th ed.). Elsevier. Rubric: Main Posting 50 to >44.0 ptsExcellentAnswers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. ... Supported by at least three current, credible sources. ... Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 44 to >39.0 ptsGoodResponds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. ... At least 75% of post has exceptional depth and breadth. ... Supported by at least three credible sources. ... Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 39 to >34.0 ptsFairResponds to some of the Discussion question(s). ... One or two criteria are not addressed or are superficially addressed. ... Is somewhat lacking reflection and critical analysis and synthesis. ... Somewhat represents knowledge gained from the course readings for the module. ... Post is cited with two credible sources. ... Written somewhat concisely; may contain more than two spelling or grammatical errors. ... Contains some APA formatting errors. 34 to >0 ptsPoorDoes not respond to the Discussion question(s) adequately. ... Lacks depth or superficially addresses criteria. ... Lacks reflection and critical analysis and synthesis. ... Does not represent knowledge gained from the course readings for the module. ... Contains only one or no credible sources. ... Not written clearly or concisely. ... Contains more than two spelling or grammatical errors. ... Does not adhere to current APA manual writing rules and style. 50 pts This criterion is linked to a Learning OutcomeMain Post: Timeliness 10 to >0.0 ptsExcellentPosts main post by Day 3. 0 ptsFairN/A 0 ptsGoodN/A 0 ptsPoorDoes not post main post by Day 3. 10 pts This criterion is linked to a Learning OutcomeFirst Response 18 to >16.0 ptsExcellentResponse exhibits synthesis, critical thinking, and application to practice settings. ... Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. ... Demonstrates synthesis and understanding of Learning Objectives. ... Communication is professional and respectful to colleagues. ... Responses to faculty questions are fully answered, if posed. ... Response is effectively written in standard, edited English. 16 to >14.0 ptsGoodResponse exhibits critical thinking and application to practice settings. ... Communication is professional and respectful to colleagues. ... Responses to faculty questions are answered, if posed. ... Provides clear, concise opinions and ideas that are supported by two or more credible sources. ... Response is effectively written in standard, edited English. 14 to >12.0 ptsFairResponse is on topic and may have some depth. ... Responses posted in the Discussion may lack effective professional communication. ... Responses to faculty questions are somewhat answered, if posed. ... Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 12 to >0 ptsPoorResponse may not be on topic and lacks depth. ... Responses posted in the Discussion lack effective professional communication. ... Responses to faculty questions are missing. ... No credible sources are cited. 18 pts This criterion is linked to a Learning OutcomeSecond Response 17 to >15.0 ptsExcellentResponse exhibits synthesis, critical thinking, and application to practice settings. ... Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. ... Demonstrates synthesis and understanding of Learning Objectives. ... Communication is professional and respectful to colleagues. ... Responses to faculty questions are fully answered, if posed. ... Response is effectively written in standard, edited English. 15 to >13.0 ptsGoodResponse exhibits critical thinking and application to practice settings. ... Communication is professional and respectful to colleagues. ... Responses to faculty questions are answered, if posed. ... Provides clear, concise opinions and ideas that are supported by two or more credible sources. ... Response is effectively written in standard, edited English. 13 to >11.0 ptsFairResponse is on topic and may have some depth. ... Responses posted in the Discussion may lack effective professional communication. ... Responses to faculty questions are somewhat answered, if posed. ... Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 11 to >0 ptsPoorResponse may not be on topic and lacks depth. ... Responses posted in the Discussion lack effective professional communication. ... Responses to faculty questions are missing. ... No credible sources are cited. 17 pts This criterion is linked to a Learning OutcomeParticipation 5 to >0.0 ptsExcellentMeets requirements for participation by posting on 3 different days. 0 ptsFairN/A 0 ptsGoodN/A 0 ptsPoorDoes not meet requirements for participation by posting on 3 different days. 5 pts Total Points: 100 You will follow the rubric pertaining to the second response. Instructions: Read a selection of your colleagues’ responses. Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not. Use at least 2 evidence based references. DOI's must be clickable.