A client with sickle cell disease asks the nurse about the effects of hemoglobin S on red blood cells.
Which statement by the nurse accurately explains the pathophysiology of this condition?

Painful vaso-occlusive crisis.

Choice A rationale:

Impaired immune function is not the primary clinical manifestation assessed in a client with sickle cell disease experiencing severe pain in the joints and abdomen.

While sickle cell disease can affect the immune system, the immediate concern in this scenario is addressing the intense pain caused by vaso-occlusion.

Choice B rationale:

Organ damage is a potential long-term complication of sickle cell disease, but it is not the primary clinical manifestation being assessed in this patient.

The description of sharp, stabbing pain in the abdomen and joint aches is indicative of a vaso-occlusive crisis, and the focus should be on pain management and addressing the crisis itself.

Choice C rationale:

The nurse is most likely assessing a painful vaso-occlusive crisis in this patient.

The description of sharp, stabbing pain and joint discomfort is consistent with the pain experienced during a vaso-occlusive crisis.

These crises are a hallmark feature of sickle cell disease, characterized by the occlusion of blood vessels by sickled red blood cells, resulting in severe pain.

Choice D rationale:

Delayed growth and development are long-term consequences of sickle cell disease, primarily seen in pediatric patients.

In this scenario, the acute issue is the pain and discomfort the patient is currently experiencing, which is more indicative of a vaso-occlusive crisis.

Choice A rationale:

"Hemoglobin S causes red blood cells to become more flexible.”.

This statement is not accurate.

Hemoglobin S (HbS) actually causes red blood cells to become less flexible and take on a characteristic sickle shape.

This change in shape is a key feature of sickle cell disease and can lead to various complications.

Choice B rationale:

"Sickle-shaped cells improve blood flow in the body.”.

This statement is incorrect.

Sickle-shaped cells do not improve blood flow.

In fact, they can impair blood flow by blocking blood vessels.

The abnormal shape of these cells makes them more likely to get stuck in small blood vessels, leading to vaso-occlusive crises and other complications.

Choice C rationale:

"Chronic hemolysis and anemia are not associated with sickle cell disease.”.

This statement is also incorrect.

Chronic hemolysis (the breakdown of red blood cells) is a hallmark of sickle cell disease.

The abnormal shape of sickle cells makes them more fragile, leading to their premature destruction, which results in anemia.

Choice D rationale:

"Sickle-shaped cells can block blood vessels and impair blood flow.”.

This is The correct answer.

Sickle-shaped red blood cells can block blood vessels, leading to vaso-occlusive crises and impaired blood flow.

This is a key part of the pathophysiology of sickle cell disease.