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Care Plan
Medical Diagnosis: sickle cell anemia with vaso-occlusive crisis
Nursing Diagnosis List
1. Impaired Comfort related to sickle cell anemia as evidenced by acute vaso-occlusive crisis. The patient’s pain should take precedence as the nursing diagnosis, because it is in all-encompassing factor that affects the client’s ability to function within the other areas of Maslow’s hierarchy of physiological needs, such as breathing and sleeping. The pain from the vaso-occlusion makes it difficult for the client to become comfortable enough to rest in addition to other factors that affect sleep patterns. The pain caused by the client’s chest pain also makes it difficult to for her to take deep, adequate breathes and to assess her lung sounds.
2. Ineffective Breathing Pattern related to acute chest syndrome secondary to sickle cell anemia as evidenced by alterations in depth of breathing. Breathing should be prioritized as the secondary nursing diagnosis, because the patient’s sickle cell anemia is presenting her with diminished lung sounds in the lower right lung. Since the primary nursing diagnosis is associated with vaso-occlusion, the client is not getting proper oxygenation to parts of their body, and interventions may include administering analgesics to treat the discomfort, of which an adverse effect may include an altered breathing pattern, it is especially important to pay attention to and assess respiratory functioning in order to treat the effects of smoking and administration of analgesics on respiratory function and assure adequate oxygenation.
3. Disturbed Sleep Pattern related to excessive noise as evidenced by reports of being awakened all night. Disturbed sleep pattern should be prioritized third, because lack of adequate rest can cause fatigue, further discomfort, and decreased ability to function and perform ADL’s which is important to a client’s self-esteem and independence.
Nursing Care Plan
Nursing Diagnosis: Acute Pain related to vaso-occlusive

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