Sickle cell disease (SCD) is one of the complex inheritance health issues that result from the presence of a mutated form of hemoglobin, hemoglobin S (HbS). The inheritance of the mutation can be homozygous or heterozygous in conjunction with another hemoglobin mutation (Sanyaolu et al., 2020). Screening for HbS after delivery is currently mandatory in the United States. It is a case-finding method that enables providers to initiate early treatment and control. Hemoglobin electrophoresis is one of the available genetic tests I would use to screen and diagnose individuals with SCD. This chromatography technique is one of the important diagnostic tests used to detect Hb variants (Arishi et al., 2021). An electrical field is applied to aid the movement of electrically charged molecules. Various pH and mediums are used, either cellulose acetate electrophoreses at alkaline pH or citrate agar at acidic pH, which help identify hemoglobin variants. Hemoglobin electrophoresis distinguishes persons who are homozygous for HbS from heterozygous. It confirms the diagnosis of SCD by showing a single band of HbS (in HbSS) or HbS with another mutant hemoglobin in compound heterozygotes (Arishi et al., 2021). If the electrophoresis results show only HbS with an HbF concentration below 30%, the diagnosis is sickle cell anemia for children with normocytic hemolytic anemia. However, if HbS and HbC are found almost equal amounts, the diagnosis is HbSC. The DNP-prepared nurse can apply the information on SCD screening by recommending the Hemoglobin electrophoresis test to newborns. The screening results can help the DNP identify the appropriate treatment interventions and provide health education to parents on how the child will be managed, thus reducing mortality rates (Brandow et al., 2022). The DNP can also use the test to detect the Hb variants present in the patients and use the results to make a diagnosis and develop treatment plans.

References

Arishi, W. A., Alhadrami, H. A., & Zourob, M. (2021). Techniques for the detection of sickle cell disease: a review. Micromachines, 12(5), 519. . https://doi.org/10.3390/mi12050519 Brandow, A. M., & Liem, R. I. (2022). Advances in the diagnosis and treatment of sickle cell disease. Journal of hematology & oncology, 15(1), 20. https://doi.org/10.1186/s13045-022-01237-z