Question

A child is admitted in sickle cell crisis. Assessment includes a low HCT, reduced BP, and symptoms of shock. The nurse deduces that the child is in which type of crisis? A. Vaso-occlusive B. Sequestration C. Hypoxemia D. Septic

Short answer

Answer: B. Sequestration crisis.

Step-by-step solution

Understand the given symptoms and signs

In this case, the child is showing a low hematocrit (HCT) level, reduced blood pressure (BP), and symptoms of shock. We need to know which type of sickle cell crisis these symptoms point towards.

Evaluate option A - Vaso-occlusive crisis

Vaso-occlusive crisis is characterized by the blockage of blood vessels by sickled red blood cells, leading to tissue ischemia and pain. Although a vaso-occlusive crisis can cause pain and reduced blood flow, it may not directly and immediately lead to low hematocrit, reduced BP, and symptoms of shock. So, this option is less likely to be the correct answer.

Evaluate option B - Sequestration crisis

Sequestration crisis occurs when a large amount of blood is trapped in organs like the spleen or liver, leading to a rapid decrease in blood circulation. This crisis is characterized by a sudden drop in hematocrit, low BP, and symptoms of shock, which matches the symptoms described in the problem. Therefore, this option is the most likely answer.

Evaluate option C - Hypoxemia crisis

Hypoxemia refers to a condition where there is an abnormally low level of oxygen in the blood. While it can be a contributing factor in a sickle cell crisis, the given symptoms of low HCT, reduced BP, and shock do not solely point towards hypoxemia crisis. So, this option is not the correct answer.

Evaluate option D - Septic crisis

A septic crisis in sickle cell disease refers to severe infection, often with fever, which can be life-threatening. This might be accompanied by low blood pressure and shock, but the low hematocrit level is not a direct symptom of a septic crisis, making this option less likely to be the correct answer.

Conclude with the most likely type of crisis

Based on the analysis of each option, it is clear that the child is most likely in a sequestration crisis, as the given symptoms match this type of crisis the best. Therefore, the correct answer is B. Sequestration.