A patient with sickle cell disease tells the nurse that she knows when the disease is going to flare because she has pain in her arms and legs. The nurse realizes this symptom is due to
1. obstructed blood flow in the small capillaries caused by the shape of the red blood cell.
2. blood loss.
3. a history of having malaria.
4. the spleen destroying the malformed red blood cells.
1
Rationale: In sickle cell disease, the red blood cell membrane is stiffer which slows down or obstructs blood flow in the small capillaries. This can lead to microvascular occlusion leading to pain in the arms and legs as well as other body areas. Blood loss is not typically seen in sickle cell disease. Having a history of malaria can explain the onset of the disease as a genetic mutation against malaria. The spleen does destroy the malformed red blood cells but this does not cause pain in the arms and legs.
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