In a school-age client diagnosed with sickle cell anemia, which finding is the highest priority?

In a school-age client diagnosed with sickle cell anemia, the highest priority finding is slurred speech. This symptom is indicative of a potential neurological complication, such as a stroke, which can be a serious event in individuals with sickle cell disease due to the risk of vaso-occlusive crises that can lead to cerebral infarction. The presence of slurred speech requires immediate assessment and intervention, as it could signify changes in cerebral blood flow or oxygenation which may lead to lasting damage if not promptly addressed.

Other findings, while significant, do not pose an immediate threat to the client's life or wellbeing in the same way. A hematocrit level of 32% indicates mild anemia, which requires management but is a common complication of sickle cell anemia. A white blood cell count of 16/mm3 shows some elevation, which may signal infection or inflammation but is not as urgent as neurological symptoms. Yellowed sclera, or jaundice, indicates elevated bilirubin levels often associated with hemolysis typical in sickle cell anemia, yet this condition also requires monitoring rather than urgent intervention.

In the context of sickle cell anemia, it is crucial to prioritize neurological symptoms such as slurred speech because they can lead to significant morbidity if not