Which of the following accurately describe the differences between vaso-occlusive crisis, sequestration crisis, and aplastic crisis in sickle cell anemia? (Select All that Apply.)

Aplastic crisis is caused by a decrease in the production of red blood cells in the bone marrow.

Sequestration crisis involves the blockage of small blood vessels by sickled red blood cells.

Vaso-occlusive crisis is characterized by the pooling of large amounts of blood in the spleen and liver.

Aplastic crisis is characterized by the pooling of large amounts of blood in the spleen and liver.

Sequestration crisis is characterized by the pooling of large amounts of blood in the spleen and liver.

Vaso-occlusive crisis involves the blockage of small blood vessels by sickled red blood cells.

Answer and Explanation

Correct Answer : A,E,F

A. Aplastic crisis is caused by a decrease in the production of red blood cells in the bone marrow is correct. Aplastic crisis is often triggered by an infection (such as parvovirus B19), leading to a sudden reduction in red blood cell production, which can exacerbate anemia.

B. Sequestration crisis involves the blockage of small blood vessels by sickled red blood cells is incorrect. This describes a vaso-occlusive crisis, not sequestration crisis. Sequestration crisis involves pooling of blood in the spleen or liver, leading to organ enlargement and circulatory collapse.

C. Vaso-occlusive crisis is characterized by the pooling of large amounts of blood in the spleen and liver is incorrect. Vaso-occlusive crisis is characterized by the blockage of small blood vessels by sickled cells, leading to pain, ischemia, and tissue damage.

D. Aplastic crisis is characterized by the pooling of large amounts of blood in the spleen and liver is incorrect. Aplastic crisis is primarily related to bone marrow failure and reduced red blood cell production, not blood pooling in organs.

E. Sequestration crisis is characterized by the pooling of large amounts of blood in the spleen and liver is correct. In sequestration crisis, the spleen and liver trap large amounts of blood, which can lead to hypovolemic shock and severe anemia.

F. Vaso-occlusive crisis involves the blockage of small blood vessels by sickled red blood cells is correct. Vaso-occlusive crisis occurs when sickled red blood cells obstruct blood flow in small vessels, causing pain, tissue damage, and potential organ dysfunction.

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Correct Answer is B

Explanation

A. Confusion and altered mental status can be signs of increased ICP, but these symptoms are not specific. Confusion or altered consciousness may also be observed in other conditions, so this alone may not definitively indicate increased ICP.

B. Increased diastolic pressure with narrowing pulse pressure is a classic sign of increased intracranial pressure and is a key component of Cushing's triad. This triad, which also includes bradycardia and irregular respirations, is a critical indicator of impending brain herniation and requires immediate intervention.

C. Irregular, rapid heartbeat is not a direct sign of increased ICP. While heart rate changes can occur with changes in ICP, they are usually seen as part of Cushing’s triad and would typically present with bradycardia, not rapid heartbeat.

D. Rapid, shallow breathing can occur in response to other conditions, but it is not the most specific or early sign of increased ICP. Changes in the respiratory pattern with increased ICP often involve more distinct alterations like Cheyne-Stokes or irregular breathing patterns.

A. Obtain IV access. B. Keep a padded tongue blade available at the client's bedside. C. Keep the lights on when the client is sleeping. D. Place the client's bed in the high position.

Correct Answer is A

Explanation

A. Obtain IV access. Obtaining IV access is a good precaution in case the client requires emergency medication (e.g., anticonvulsants) to control seizures. This is part of preparing for seizure management.

B. Keep a padded tongue blade available at the client's bedside. This is an outdated practice. The nurse should never insert a tongue blade into a patient's mouth during a seizure as it can cause injury.

C. Keep the lights on when the client is sleeping. There is no need to keep the lights on, as it may disturb the client’s rest. A calm, quiet environment is preferred, and seizure precautions are more related to safety and monitoring than lighting.

D. Place the client's bed in the high position. This increases the risk of injury in the event of a seizure. The bed should be in a low position with side rails up to prevent injury.

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Which of the following accurately describe the differences between vaso-occlusive crisis, sequestration crisis, and aplastic crisis in sickle cell anemia? (Select All that Apply.)

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