In caring for a pregnant client with sickle-cell disease, which concern is recognized as the priority?

In the context of caring for a pregnant client with sickle-cell disease, the priority concern is often decreased fluid volume. This is due to the fact that sickle-cell disease increases the risk of vaso-occlusive crises, where red blood cells take on a rigid, sickle shape and can block blood flow. Adequate hydration is crucial for maintaining blood volume and preventing these crises.

During pregnancy, the body's fluid requirements increase, and the risk of dehydration can worsen the condition. Therefore, ensuring that the mother maintains proper hydration helps minimize the risk of complications associated with sickle-cell disease, such as pain episodes and other serious health issues.

Other aspects, such as nutrition, coping mechanisms, and activity tolerance, are indeed significant in the holistic care of a pregnant woman with this condition, but the immediate concern regarding fluid volume and its impact on circulation and overall health makes it the primary focus. Adequate hydration supports both maternal and fetal well-being, emphasizing its critical role in this clinical context.