A clinic nurse instructs the mother of a child with sickle cell disease about the precipitating factors related to pain crisis. Which of the following, if identified by the mother as a precipitating factor, indicates the need for further instructions?
A. Infection
B. Trauma
C. Fluid overload
D. Stress
Correct Answer: C. Fluid overload
Pain crises may be precipitated by infection, dehydration, hypoxia, trauma, or physical or emotional stress. The mother of a child with sickle cell disease should encourage fluid intake of 1 ½ to 2 times the daily requirement to prevent dehydration.
Option A: People with sickle cell disease have an increased risk of developing certain infections. They include pneumonia, bloodstream infections, meningitis, and bone infections. In people with sickle cell disease, the spleen does not work correctly. The spleen is an organ in the abdomen that helps protect against infection.
Option B: Sickle cell trait, though considered as a benign condition may lead to sight-threatening complications in the presence of precipitating factors. Impact of blunt trauma may lead to localized hypoxia, promoting sickling of erythrocytes leading to vaso-occlusion and resultant stagnation of blood.
Option D: Mental stress and the anticipation of pain decreases microvascular blood flow, which may trigger episodes of vaso-occlusive crisis among patients with sickle cell disease, according to study results presented at the American Physiological Society’s Physiological and Pathophysiological Consequences of Sickle Cell Disease conference.
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