CRNE Exam Prep

Category - Changes in Health

John Isles, a 10-year-old client with sickle cell disease, is admitted for sickle cell crisis. Initials assessment shows a temperature of 38.2°Cand swelling in the left leg. The client complains of severe pain in the affected extremity. The nurse recognizes this as what type of sickle cell crisis?
  1. Vaso-occlusive
  2. Hypovolemic
  3. Aplastic
  4. Sequestration
Explanation
Answer: A - The client exhibits a vaso-occlusive crisis. Vaso-occlusive crisis is caused by occlusion of blood vessels due to sickled cells. The location of pain depends on the area of occlusion, but it is often reported in the arms, legs, and chest. Younger children experience swelling of the fingers and toes. Aplastic crisis occurs due to human parvovirus infection resulting in rapid fall of the hemoglobin level. Sequestration crisis is characterized by pooling of sickle cells in the spleen, causing a rapid drop in hemoglobin and hematocrit levels. Option B is not a known type of sickle cell crisis.
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