A nurse is providing care to an infant newly diagnosed with sickle cell anemia. The infant's parents ask the nurse to describe what sickled red blood cells are and how they affect blood flow. Which of the following statements should the nurse include in the discussion? (Select all that apply.)

A. Healthy red blood cells are flexible and biconcave, which allows them to navigate through narrow capillaries easily. In contrast, sickled cells are rigid and less deformable, which obstructs blood flow, increases the risk of vascular occlusion, and contributes to painful crises and tissue ischemia. B. Sickle cells are crescent-shaped (C-shaped) rather than the normal biconcave disc. This abnormal shape causes the cells to clump together and adhere to the walls of small blood vessels, leading to blockages, reduced oxygen delivery, and inflammation. This contributes to pain crises, organ damage, and increased susceptibility to infections. C. Sickled red blood cells have a shortened life span of 10–20 days, compared to approximately 120 days for healthy red blood cells. This rapid destruction results in chronic hemolytic anemia, fatigue, pallor, and increased cardiac workload as the body attempts to compensate. D. The rigidity of sickle cells is a central feature of sickle cell anemia. Because they cannot deform easily, they obstruct capillaries, limiting oxygen delivery to tissues, triggering painful vaso-occlusive episodes, and increasing the risk of organ damage, stroke, and other complications. E. Donut-shaped red blood cells refer to normal biconcave erythrocytes, which are flexible and do not clump in small vessels. This description does not reflect sickle cell pathology and is therefore inaccurate. F. The premature destruction of sickle cells in the spleen or circulation causes chronic anemia, which reduces the oxygen-carrying capacity of the blood. Children may experience fatigue, pallor, delayed growth, and tachycardia as the body attempts to compensate for low hemoglobin levels.