A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect?

Choice A rationale Sickle cell crisis often leads to increased sympathetic activity and compensatory mechanisms due to pain and hypoxemia. This typically results in tachycardia, an elevated heart rate, as the body attempts to increase oxygen delivery to tissues, rather than bradycardia, which is a slower-than-normal heart rate. Choice B rationale Vaso-occlusion in sickle cell crisis can affect gastrointestinal perfusion, potentially leading to abdominal pain and ileus, but it typically does not cause constipation as a primary finding. Diarrhea, or changes in bowel habits, can occur if there is significant mesenteric ischemia, but constipation is not a characteristic symptom. Choice C rationale Vaso-occlusive crises in sickle cell disease lead to obstruction of blood flow in small vessels, causing localized ischemia and inflammation. This impaired microcirculation often results in fluid extravasation into interstitial spaces, leading to swelling and peripheral edema, particularly in affected limbs or digits. Choice D rationale In sickle cell crisis, renal blood flow can be compromised due to sickling in the renal medulla. This can lead to decreased glomerular filtration and impaired renal concentrating ability, often resulting in decreased urine output and potentially acute kidney injury, rather than an increased urine output.