A nurse is assessing a child who is in a sickle cell crisis. Which of the following findings should the nurse expect?
A.
Constipation
B.
Pain
C.
High fever
D.
Bradycardia
The correct answer and Explanation is :
The correct answer is B. Pain.
In a sickle cell crisis, pain is a primary symptom that typically results from the obstruction of blood flow due to sickled red blood cells. These cells can clump together and block blood vessels, leading to reduced oxygen delivery to tissues and organs. This blockage causes ischemia and inflammation, resulting in severe pain known as a vaso-occlusive crisis.
Here’s a detailed explanation:
Pathophysiology and Pain in Sickle Cell Crisis:
Sickle cell disease (SCD) is a genetic disorder where red blood cells are abnormally shaped, resembling a crescent or sickle rather than the normal disc shape. These sickled cells have difficulty passing through small blood vessels, causing blockages. When these blockages occur, they restrict blood flow and oxygen to tissues, leading to a cascade of pain and inflammation.
The pain experienced during a sickle cell crisis, also known as a vaso-occlusive crisis, can be severe and is often described as aching, throbbing, or sharp. It usually affects the bones, joints, and sometimes the abdomen. This pain is a direct result of the reduced blood flow and the resulting hypoxia (low oxygen levels) in the affected tissues.
Other Findings in Sickle Cell Crisis:
- Constipation (A): While constipation can be a concern in children with sickle cell disease, especially if they are on certain pain medications like opioids, it is not a primary symptom of a sickle cell crisis.
- High fever (C): While infections can occur due to compromised immunity in sickle cell patients, high fever is not a hallmark symptom of a sickle cell crisis itself. However, it’s important to monitor for fever as it could indicate an infection that might complicate the crisis.
- Bradycardia (D): Bradycardia, or a slow heart rate, is not a typical feature of a sickle cell crisis. Instead, the stress and pain of the crisis might lead to tachycardia (an increased heart rate).
In summary, pain is the most characteristic symptom of a sickle cell crisis, making it crucial for nurses and healthcare providers to assess and manage pain effectively in these patients.