For a woman at 37 weeks' gestation with sickle cell anemia, which problem should be prioritized in the nursing care plan?

In the care of a pregnant woman at 37 weeks' gestation with sickle cell anemia, prioritizing the problem of insufficient fluid volume is critical. Sickle cell anemia can lead to complications such as vaso-occlusive crises, which are often triggered by dehydration. Adequate hydration helps to maintain blood flow and reduce the risk of sickling of red blood cells, thus preventing crises and ensuring both maternal and fetal well-being.

Ensuring proper fluid volume can also positively impact the overall health of the mother and the fetus, as it helps manage blood viscosity and circulation. This becomes particularly important in the later stages of pregnancy, where increased blood volume and the demands of the developing fetus must be balanced against the risks associated with sickle cell disease.

While pain management, monitoring of fetal movement, and education on dietary needs are important aspects of care for this patient population, they are secondary to ensuring sufficient hydration. Only by addressing the risk of dehydration can the nurse help to prevent more severe complications that could arise from sickle cell anemia during pregnancy.