Sickle Cell Crisis: NCLEX Priorities
Vaso-occlusive crisis: pain control (opioids), hydration, O2, infection workup.
Sickle cell crisis is intensely painful. NCLEX tests pain management with opioids and the precipitants.
Recognition
Severe bone/joint pain. Chest pain (acute chest syndrome, emergency). Splenic sequestration in kids. Priapism. Stroke.
Treatment
Hydration (IV NS), opioids (don't undertreat), O2 if hypoxic, treat infection, transfusion if severe. Hydroxyurea reduces frequency.
Precipitants
Dehydration, hypoxia, infection, cold exposure, stress, high altitude.
Acute chest syndrome
New infiltrate + respiratory symptoms. Antibiotics, transfusion, supportive care. High mortality if not aggressive.
Frequently asked
Why opioids if drug-seeking concern?
Sickle pain is real and severe. Undertreating breeds distrust and worse outcomes. Use PCA for transparency.
Bone marrow transplant, curative?
Yes, for select patients with matched donor.
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