What is the highest priority problem for a pregnant client with sickle cell anemia?

In the context of a pregnant client with sickle cell anemia, dehydration is considered the highest priority problem because it can significantly impact the overall health of both the mother and the fetus. Sickle cell anemia is characterized by the presence of abnormally shaped red blood cells that can obstruct blood flow, leading to vaso-occlusive crises. Dehydration can exacerbate the sickling of red blood cells, increasing the risk of these painful crises and potentially leading to complications such as splenic sequestration or acute chest syndrome.

When a pregnant woman becomes dehydrated, her blood volume decreases, which can further impair circulation and oxygen delivery to vital organs, including the uterus and placenta. This can lead to fetal distress and growth issues. Therefore, maintaining adequate hydration is crucial to preventing complications and ensuring both maternal and fetal well-being.

While anemia, preeclampsia, and hypoxia are all important concerns in the context of sickle cell anemia during pregnancy, dehydration is particularly critical as it directly influences the likelihood of vaso-occlusive events and the overall stability of the patient's condition.