In a child with sickle cell anemia (SCA), adequate hydration is ...

[eruditmonkey@yahoo.com]

In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxiaischemia cycle. What information should the nurse share with parents in a teaching plan?
 
  a. Encourage drinking.
  b. Keep accurate records of output.
  c. Check for moist mucous membranes.
  d. Monitor the concentration of the child's urine.

Question 2

The clinical manifestations of sickle cell anemia (SCA) are primarily the result of which physiologic alteration?
 
  a. Decreased blood viscosity
  b. Deficiency in coagulation
  c. Increased red blood cell (RBC) destruction
  d. Greater affinity for oxygen

[carolinefletcherr]

Answer to Question 1

ANS: C
Children with SCA have impaired kidney function and cannot concentrate urine. Parents are taught signs of dehydration and ways to minimize loss of fluid to the environment. Encouraging drinking is not specific enough for parents. The nurse should give the parents and child a target fluid amount for each 24-hour period. Accurate monitoring of output may not reflect the child's fluid needs. Without the ability to concentrate urine, the child needs additional intake to compensate. Dilute urine and specific gravity are not valid signs of hydration status in children with SCA.

Answer to Question 2

ANS: C
The clinical features of SCA are primarily the result of increased RBC destruction and obstruction caused by the sickle-shaped RBCs. When the sickle cells change shape, they increase the viscosity in the area where they are involved in the microcirculation. SCA does not have a coagulation deficit. Sickled red cells have decreased oxygen-carrying capacity and transform into the sickle shape in conditions of low oxygen tension.