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학습 자료 둘러보기 →In a vaso-occlusive crisis, the most critical nursing action to prevent acute chest syndrome (ACS) is immediate initiation of incentive spirometry. The goal is 10 deep breaths every 2 hours while awake to combat splinting and atelectasis.
Assess for early signs of ACS, which include a rapid, shallow respiratory pattern, tachypnea with a rate over 30 breaths/min, and a drop in oxygen saturation. This reflects pulmonary microvascular sickling and ventilation-perfusion mismatch.
Do not rely solely on oxygen saturation readings; a value of 92% may be baseline. Shallow breathing is an ominous sign indicating high risk for hypoventilation and progressive respiratory failure, warranting immediate intervention over fever or baseline anemia.
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