NCLEX Practice Test

A client with sickle cell crisis reports severe generalized pain. Which intervention is a priority for correcting vasoocclusion?

1. Administering high-flow IV fluids

2. Applying oxygen via nasal cannula

3. Maintaining strict bed rest

4. Transfusing packed red blood cells

The correct answer is: Administering high-flow IV fluids

In the context of a sickle cell crisis, the primary concern revolves around the occurrence of vaso-occlusion, which is where the sickle-shaped red blood cells obstruct blood flow. This obstruction leads to tissue hypoxia and significant pain due to diminished oxygen delivery. Administering high-flow IV fluids is a critical intervention because it helps to improve blood volume and viscosity. Increased hydration allows for better circulation and can help the sickled cells to more easily navigate through the vasculature, thereby alleviating the blockage and reducing the pain. Additionally, fluids help to prevent further sickling of red blood cells by promoting a less viscous blood environment, which is essential for ensuring adequate perfusion to tissues. While applying oxygen can be beneficial, especially if there is evidence of hypoxia, it does not address the immediate cause of pain due to vaso-occlusion directly as effectively as rehydration does. Maintaining strict bed rest may assist in reducing metabolic demands, but it does not actively resolve the issue of obstructed blood flow. Transfusing packed red blood cells may be necessary in some cases, particularly if there is a severe anemia or significant complications, but it is not the immediate intervention for vaso-occlusive crisis. Therefore, the administration of high