impaired Gas Exchange may be related to decreased oxygen-carrying capacity of blood, reduced RBC life span, abnormal RBC structure, increased blood viscosity, predisposition to bacterial pneumonia/pulmonary infarcts, possibly evidenced by dyspnea, use of accessory muscles, cyanosis/signs of hypoxia, tachycardia, changes in mentation, and restlessness.

ineffective Tissue Perfusion: [specify] may be related to stasis, vaso-occlusive nature of sickling, inflammatory response, atrioventricular (AV) shunts in pulmonary and peripheral circulation, myocardial damage (small infarcts, iron deposits, fibrosis), possibly evidenced by signs and symptoms dependent on system involved, for example: renal: decreased specific gravity and pale urine in face of dehydration; cerebral: paralysis and visual disturbances; peripheral: distal ischemia, tissue infarctions, ulcerations, bone pain; cardiopulmonary: angina, palpitations.

acute/chronic Pain may be related to intravascular sickling with localized vascular stasis, occlusion, infarction/necrosis and deprivation of oxygen and nutrients, accumulation of noxious metabolites, possibly evidenced by reports of localized, generalized, or migratory joint and/or abdominal/back pain; guarding and distraction behaviors (moaning, crying, restlessness), facial grimacing, narrowed focus, and autonomic responses.

deficient Knowledge [Learning Need] regarding disease process, genetic factors, prognosis, self-care and treatment needs may be related to lack of exposure/recall, misinterpretation of information, unfamiliarity with resources, possibly evidenced by questions, statement of concern/misconceptions, exacerbation of condition, inadequate follow-through of therapy instructions, and development of preventable complications.

delayed Growth and Development may be related to effects of physical condition, possibly evidenced by altered physical growth and delay/difficulty performing skills typical of age group.

risk for sedentary Lifestyle: risk factors may include lack of interest/motivation, resources; lack of training or knowledge of specific exercise needs, safety concerns/fear of injury.

compromised family Coping may be related to chronic nature of disease/disability, family disorganization, presence of other crises/situations impacting significant person/parent, lifestyle restrictions, possibly evidenced by significant person/parent expressing preoccupation with own reaction and displaying protective behavior disproportionate to patient's ability or need for autonomy.