The nurse is conducting a staff in-service on sickle cell anemia. Which describes the pathologic changes of sickle cell anemia?

A) Sickle-shaped cells carry excess oxygen.
B) Sickle-shaped cells decrease blood viscosity.
C) Increased red blood cell destruction occurs.
D) Decreased adhesion of sickle-shaped cells occurs.

The clinical features of sickle cell anemia are primarily the result of increased red blood cell destruction and obstruction caused by the sickle-shaped red blood cells. Sickled red cells have decreased oxygen-carrying capacity and transform into the sickle shape in conditions of low oxygen tension. When the sickle cells change shape, they increase the viscosity in the area where they are involved in the microcirculation. Increased adhesion and entanglement of cells occurs.