A nurse is reviewing the medical history of a child diagnosed with sickle cell disease.
The child's parent reports, "My child always looks pale and gets tired very easily.”.
Based on this information, which complication of sickle cell disease is the nurse most likely assessing in this patient?

Jaundice and dark urine.

Choice A rationale:

Pale skin and nail beds are not typically the primary clinical manifestations of sickle cell disease during a crisis.

Sickle cell crises are primarily characterized by vaso-occlusive events leading to severe pain.

While paleness may occur due to anemia associated with sickle cell disease, it is not the hallmark manifestation during a crisis.

Choice B rationale:

An elevation in blood pressure is not a specific clinical manifestation of sickle cell disease.

In fact, individuals with sickle cell disease may experience a drop in blood pressure during a crisis due to reduced blood flow and organ perfusion.

Elevated blood pressure is more likely to be associated with other health conditions or stressors.

Choice C rationale:

Swelling of the lower extremities is not a typical clinical manifestation of sickle cell disease during a crisis.

The hallmark features of a sickling crisis include pain, jaundice, and, in some cases, dark urine, which results from the breakdown of sickled red blood cells.

Swelling may occur in other conditions but is not specific to sickle cell disease.

Choice D rationale:

Jaundice and dark urine are crucial clinical manifestations to monitor in a client with sickle cell disease during a crisis.

Jaundice indicates the breakdown of red blood cells, which is a common occurrence during vaso-occlusive events.

Dark urine results from the excretion of bilirubin, a byproduct of red blood cell breakdown.

These manifestations provide important diagnostic information and guide treatment.

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.