Sickle Cell Disease EAQ

A child with sickle cell anemia is experiencing a painful episode (vaso-occlusive crisis). The nurse assesses the child, obtains the child's vital signs, and reviews the child's laboratory test results. Which is the prioritynursing action? 1 Providing oxygen therapy 2 Administering an analgesic 3 Initiating a blood transfusion 4 Monitoring intravenous fluids

2

A client with sickle cell anemia is experiencing a painful episode (vaso-occlusive crisis) and has a patient-controlled analgesia (PCA) pump. The current pain rating is 5 on a scale of 1 to 10 at the right elbow. The nurse observes that the pump is "locked out" for another 10 minutes. Which action would the nurse implement? 1 Turning on the television for diversion 2 Placing the prescribed as-needed warm, wet compress on the elbow 3 Calling the primary health care provider for another analgesic prescription 4 Informing the client gently that she must wait until the pump reactivates to get more medication

2

After the nurse has finished teaching a client about sickle cell anemia, which statement indicates that the client has a correct understanding of the condition? 1 "I have abnormal platelets." 2 "I have abnormal hemoglobin." 3 "I have abnormal hematocrit." 4 "I have abnormal white blood cells."

2

A 6-year-old child with sickle cell disease is admitted with a vasoocclusive crisis (pain episode). Which are the priority nursing concerns? Select all that apply. One, some, or all responses may be correct. 1 Nutrition 2 Hydration 3 Pain management 4 Prevention of infection 5 Oxygen supplementation

2,3,5

Which actions would the nurse take when admitting a client having a sickle cell crisis to the nursing unit? Select all that apply. One, some, or all responses may be correct. 1 Place on strict isolation. 2 Administer hydroxyurea. 3 Administer aspirin 325 mg daily. 4 Apply oxygen via nasal cannula. 5 Administer intravenous (IV) hydration. 6 Avoid opiate-type analgesics.

2,4,5

A 4-year-old child diagnosed with sickle cell anemia is at a high risk of acquiring pneumococcal diseases. The child has previously received two doses of the pneumococcal conjugate vaccine (PCV). Based on the immunization protocol, which dose of PCV should the nurse administer? 1 Administer four more doses of PCV. 2 Administer three more doses of PCV. 3 Administer two more doses of PCV. 4 Administer one more dose of PCV

3

A pregnant client and her husband tell the nurse they have a 1-year-old daughter with sickle cell anemia, but that they themselves do not have the disease. Which response would correctly answer the clients' question, "Will this baby also have sickle cell anemia?" 1 "The chance that another child will have sickle cell anemia is 25%." 2 "Only one child in a family is affected, so the others will probably be all right." 3 "The most likely conclusion is that your children will have sickle cell anemia." 4 "If your partner has the sickle cell gene, 50% of your children will have sickle cell anemia."

1

The nurse concludes that the teaching about sickle cell anemia has been understood when an adolescent with the disorder makes which statement? 1 "I'll start to have symptoms when I drink less fluid." 2 "I'll start to have symptoms when I have fewer platelets." 3 "I'll start to have symptoms when I decrease the iron in my diet." 4 "I'll start to have symptoms when I have fewer white blood cells."

1

Which is the most appropriate nursing intervention for an adolescent child with sickle cell anemia? 1 Teaching the family how to limit sickling episodes 2 Preparing the child for occasional blood transfusions 3 Educating the family about prophylactic medications 4 Explaining to the child how excess oxygen causes sickling

1

Which value for hemoglobin would the nurse expect in a client who is experiencing sickle cell crisis? 1 6 to 8 g/100 mL (60-80 mmol/L) 2 10 to 12 g/100 mL (100-120 mmol/L) 3 12 to 14 g/100 mL (120-140 mmol/L) 4 16 to 18 g/100 mL (160-180 mmol/L)

1

The parents of a child with sickle cell anemia (SSA) tell the nurse, "We have never had any symptoms of SSA and do not understand why our child has this problem." Which information will the nurse include when teaching the parents? 1 SSA is caused by a random genetic mutation with no known cause. 2 People who are carriers of SSA may not have symptoms, but all of their children will have SSA. 3 If both parents are carriers of SSA, there is a 25% chance that offspring will have SSA. 4 When a child is born with SSA, genetic testing of both parents is needed to determine if they have sickle cell trait.

3.

An adolescent child with sickle cell anemia is admitted to the pediatric unit during a vaso-occlusive crisis. Which pathophysiology is correct? 1 Severe depression of the circulating thrombocytes 2 Diminished red blood cell (RBC) production by the bone marrow 3 Pooling of blood in the spleen with splenomegaly as a consequence 4 Blockage of small blood vessels as a result of clumping of RBCs

4

Confidence: Nailed It Stats 10.The nurse is teaching a pregnant client with sickle cell anemia about the importance of taking supplemental folic acid. Which response by the nurse explains how folic acid would help? 1 "It lessens sickling of red blood cells." 2 "It prevents vaso-occlusive crises." 3 "It helps decrease the cellular oxygen need." 4 "It will promote production of hemoglobin."

4

The parent of a child with sickle cell anemia tells the nurse that the family is going camping by a lake in the mountains this summer. The parent inquires what activities are appropriate. Which activity would the nurse suggest? 1 Swimming in the lake 2 Soccer with the family 3 Climbing the mountain trails 4 Motorboat rides around the lake

4

Which is the nurse's priority when evaluating a child with sickle cell anemia whose spleen autoinfarcted 2 years prior? 1 Monitoring for signs of jaundice 2 Assessing the abdomen frequently 3 Monitoring serial hematocrit readings 4 Determining parental knowledge about infection

4