51. An 18-year-old client, who is gravida 4, para 0, has been treated for sickle cell anemia since age 5. She is admitted to labor and delivery at 37 weeks' gestation in the latent phase of labor with spontaneous rupture of membranes. Which client need should a nurse anticipate?
Test-Taking Tip
The question states the client has been treated for sickle cell anemia, but does not state she has a current sickle cell crisis. Management of a sickle cell crisis may include blood transfusion (Answer 3).
Content Area: Maternity, Intrapartum; Integrated Process: Nursing Process, Planning; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Potential for Alterations in Body Systems
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Answer 1 is incorrect because proper hydration is important during labor. There is no reason for fluid restriction. Answer 2 is correct because supplemental oxygen is needed to compensate for the decreased oxygen-carrying capacity of sickling cells. Answer 3 is incorrect because a blood transfusion is usually not required unless there is a significant blood loss during delivery. Prophylactic blood transfusions are not recommended. Answer 4 is incorrect because there is a higher risk in operative deliveries, especially of blood loss. Unless an operative delivery is obstetrically indicated, a vaginal delivery is the preferred method of delivery.
