Sickle cell anemia

Among the anemias, which symptom is unique to sickle cell disease? Fatigue, pallor, shortness of breath Pain and swollen joints and extremities Tachycardia and tachypnea Low hemoglobin and hematocrit levels

Pain and swollen joints and extremities Rationale: Pain is caused by tissue hypoxia and clumping of cellular debris, particularly in the joints, bones, chest, and abdomen leading to vasoocclusion and swelling.

Which is most appropriate to teach the family of the child with sickle cell disease (SCD) about preventing infections? "Get the flu vaccine every 3 years." "Have tuberculin skin testing done every 6 months." "Get a pneumococcal vaccine every 2 years." "Inspect cuts, sores, and insect bites carefully."

"Inspect cuts, sores, and insect bites carefully."

Which patient is most likely to be affected by sickle cell disease (SCD)? A member of an Indian tribe A person of Cuban nationality A person of tropical African descent An individual of Middle Eastern origin

A person of tropical African descent Rationale: Sickle cell disease predominantly affects people of tropical African descent.

The nurse is caring for a client with sickle cell disease who presents to the hospital in sickle cell crisis. What is the priority nursing action? Start an intravenous site and administer fluids per healthcare provider order. Medicate the client that has pain with an opioid pain medication per healthcare provider order. Push oral fluids per healthcare provider order. Administer oxygen per healthcare provider order.

Administer oxygen per healthcare provider order.

Given Kaitlyn's admitting symptoms of severe pain, shortness of breath, fever, and oxygen saturation of 92%, what should be the nurse's first action? Deliver IV pain medications. Begin intravenous solutions. Administer oxygen. Administer an antipyretic.

Administer oxygen. During sickle cell crisis, oxygen assists in decreasing hypoxia and minimizing the severity of the crisis. Administering paid medications and antipyretics and providing hydration are important interventions, but they aren't the priority.

The nurse is caring for a patient diagnosed with autonomic dysreflexia (AD). Which action performed by the nurse indicates a need for correction? Placing an indwelling urinary catheter in the patient Applying antiembolism stockings on the patient Monitoring the patient's blood pressure every 5 minutes Checking the patient's body for the presence of pressure ulcers

Applying antiembolism stockings on the patient

The nurse is talking with the client about possible complications of sickle cell disease. What possible complications would the nurse include? Select all that apply. Chronic kidney disease Diabetes Cerebrovascular accidents Infection Pulmonary infarctions

Cerebrovascular accidents Infection Pulmonary infarctions

What medication should the nurse deliver for Kaitlyn's extreme pain? Acetaminophen NSAIDS Codeine Opiates

Opiates Analgesia, usually from opiates, is administered for severe pain. Alternative and complementary treatments for pain management can also be taught to and employed by the client to minimize the use of strong analgesics.

A client is admitted to the nurse's unit with sickle cell crisis. What are the priority medical interventions that the nurse would expect to be ordered by the healthcare provider? Select all that apply. Place the client on ordered oxygen. Initiate oral and parenteral fluids per order. Medicate the client for pain. Order an electrocardiogram. Order ultrasound of the abdomen.

Place the client on ordered oxygen. Initiate oral and parenteral fluids per order. Medicate the client for pain.

The client who has sickle cell anemia developed the condition of hand-foot syndrome because of what physiological process? Repeated crisis and infarction of the bones leading to uneven development of fingers and toes Damage to the liver related to repeat sickle cell crisis Repeat crisis and infarction involving the circulatory system of the arms and legs Damage to the kidneys related to repeat sickle cell crisis

Repeated crisis and infarction of the bones leading to uneven development of fingers and toes

Which disease is inherited from parents and shown in this image? Leukemia Thrombocytopenia Sickle cell anemia Folic acid deficiency

Sickle cell anemia

Which is true regarding sickle cell disease (SCD)? Select all that apply. The sickle cell trait (SCT) is present in one of the parents of the patient. The patient has some protection against malaria. The patient has red blood cells (RBCs) that are extremely malleable. The RBCs become elongated when exposed to decreased tension. The life span of RBCs in the patient is 15 to 20 days.

The patient has some protection against malaria. The RBCs become elongated when exposed to decreased tension. The life span of RBCs in the patient is 15 to 20 days.

The nurse is speaking to the client diagnosed with sickle cell disease about lifestyle changes to prevent sickle cell crisis. What would be the most important information to include in the education plan? Increase dietary intake of fresh fruits and vegetables. Take medications only when you cannot manage your symptoms. Avoid dehydration, cold temperatures, infection, and high altitudes. Attempt to sleep 10-12 hours a night.

Avoid dehydration, cold temperatures, infection, and high altitudes.

Kaitlyn states that she has been very busy with school lately and drinking less water. Which statement is the appropriate patient education for the nurse to provide? Being adequately hydrated helps blood move freely through capillary beds. Warm beverages are best to vasodilate your stomach mucosa. Keeping busy is good for the prevention of crisis. It's good to drink water if you are able.

Being adequately hydrated helps blood move freely through capillary beds. The client with sickle cell disease should avoid dehydration. Being adequately hydrated helps blood move freely through capillary beds and prevents crisis.

Kaitlyn asks to talk with the nurse privately. She tells the nurse that all of the other girls in class have started their periods "years ago," and she is concerned that "something is wrong with me." What would be your best response about her concerns? "Everyone develops in their own way. You are fine." "That is a great question for you to ask your doctor." "It is common for teens with sickle cell disease to have a delay in their development." "Something must be wrong because most teens your age started their periods years ago."

"It is common for teens with sickle cell disease to have a delay in their development." It is common for puberty to be delayed in teenagers with sickle cell disease. You should let the client know if she is concerned. If so, she could speak further with her doctor about the concern; however, it is normal for clients with sickle cell to start menstruating later than their peers. You should acknowledge the client's concerns and not dismiss the concerns as though everything is fine because the client does not understand this common side effect of her disease.

Kaitlyn states she wishes to do anything she can to avoid getting an infection when she is discharged from the hospital. What information should the nurse share with her about avoiding infection? Select all that apply. "Monitor cuts and sores." "Plan to receive an influenza vaccine every year." "Avoid eating raw fruits and vegetables." "Perform good dental hygiene." "Avoid childhood vaccinations."

"Monitor cuts and sores." "Plan to receive an influenza vaccine every year." "Perform good dental hygiene." You would educate the client to wash her hands frequently, plan to receive an influenza vaccine every year, perform good dental hygiene, and monitor any cuts, sores, or insect bites. Getting enough sleep helps strengthen the immune system. All childhood vaccines and boosters are especially important for people with sickle cell disease.

Which is the most beneficial instruction that the nurse can teach a patient about preventing a sickle cell crisis? "Refrain from taking too much water." "Refrain from travelling in depressurized airplanes." "Perform regular workouts and brisk walking." "Wear tight-fitting clothes."

"Refrain from travelling in depressurized airplanes."

The client with sickle cell anemia is at high risk of respiratory infections. What client teaching would the nurse include when addressing this topic? Select all that apply. Get an influenza immunization every year. Stay updated on the pertussis immunization. Stay updated on the yellow fever immunization. Have a tuberculosis skin test every 5 years. Stay updated on pneumococcal immunization.

Get an influenza immunization every year. Stay updated on the pertussis immunization. Stay updated on pneumococcal immunization.

The nurse will include discharge teaching about how to prevent infection with the sickle cell anemia client. Which of these would be included in the discharge teaching plan? Select all that apply. Get enough rest to keep the immune system strong. Wash your hands frequently. Avoid raw fruits and vegetables. Receive annual influenza vaccine. Avoid dehydrating drinks

Get enough rest to keep the immune system strong. Wash your hands frequently. Receive annual influenza vaccine. Avoid dehydrating drinks

Kaitlyn asks the nurse if there is a cure for her sickle cell disease. What promising new treatments can the nurse mention? Select all that apply. Radiation therapy Hydroxyurea High dose iron therapy Complete blood transfusions Peripheral stem cell transplantation

Hydroxyurea Complete blood transfusions Peripheral stem cell transplantation Several promising new treatments for SCD include the use of hydroxyurea, complete blood transfusions, and peripheral stem cell transplantation. Hydroxyurea, a chemotherapeutic agent, increases fetal hemoglobin production and is being used selectively.

With the client's pain of 9 on a 0-10 scale and oxygen saturation of 92%, a priority nursing diagnosis would be which of the following? Impaired tissue perfusion Activity intolerance Acute pain Knowledge deficit

Impaired tissue perfusion Although all of the above nursing diagnoses could be appropriate, the priority one would be impaired tissue perfusion, which has to do with circulation. The pain and oxygen saturation she is experiencing are related to hypoxic tissue.

Kaitlyn, a teenage female client with sickle cell disease, has been admitted to the nursing unit with a diagnosis of sickle cell crisis. She is experiencing severe pain in her joints and shortness of breath, and has a temperature of 101.2°F. Kaitlyn's oxygen saturation on admission was 92%. She rates her pain at a 9 on a 0-10 scale.What explanation should the nurse give to Kaitlyn when she asks what causes the pain she is feeling? Inflammation of nerve endings related to fever Lack of blood circulation and oxygen into part of the body Presence of lactic acid in the muscle tissue Physical activity related to disease process

Lack of blood circulation and oxygen into part of the body When sickle cells clump together and block capillaries, blood circulation to certain parts of the body is blocked. This decreased blood flow causes pain.

The nurse is caring for a patient with sickle cell anemia who is experiencing sequestration crisis. Which best describes this? The bone marrow has ceased the production of red blood cells (RBCs). The blood vessels are obstructed by hemolyzed cells. There is a massive collection of RBCs in the spleen. The RBCs undergo hemolysis at an increased rate.

There is a massive collection of RBCs in the spleen. Rationale: Sequestration crisis is caused by a sudden, massive pooling of RBCs in the spleen with resulting hypovolemic shock and cardiovascular failure.

The nurse is explaining to the nursing student why the client with sickle cell disease is at risk for thrombi forming in the capillary beds in the circulatory system. What is the nurse's best explanation for why this occurs? The sickle-shaped red blood cell is stiffer and more fragile than normally shaped red blood cells. Because of this, the cells can more easily hemolyze and clump in the capillary beds. The sickle-shaped red blood cell is flexible and has a sticky, gummy surface. Because of this, the cells clump in the capillary beds. The sickle-shaped red blood cells stick to the wall of the larger blood vessels. Thrombi are formed in the large vessels and move into the small capillary beds. The sickle-shaped red blood cells are larger and as the cells move into the smaller vessels, such as the capillary beds, the cells block blood flow.

The sickle-shaped red blood cell is stiffer and more fragile than normally shaped red blood cells. Because of this, the cells can more easily hemolyze and clump in the capillary beds.

A patient is experiencing an acute episode of sickle cell crisis. What treatments should the nurse request from the healthcare provider? Select all that apply. Oxygen Blood transfusion Opioid pain medication Intravenous fluids Antipyretics

Oxygen Opioid pain medication Intravenous fluids

The nurse caring for the client with sickle cell anemia is aware that which factors could precipitate a sickle cell crisis? Select all that apply. Dehydration Cold temperature Infection Swimming Traveling to high altitudes

Dehydration Cold temperature Infection Traveling to high altitudes

The parent of a teen in sickle cell crisis asks the nurse about the long-term impact of these acute episodes. What complications are possible? Select all that apply. Hand-foot syndrome Delayed puberty Cognitive impairment Diabetes Psychosocial issues

Hand-foot syndrome Delayed puberty Cognitive impairment Psychosocial issues

The nurse is teaching about the most common causes of death in the patient with sickle cell disease (SCD). What should the nurse include? Select all that apply. Infection Hypertensive crisis Stroke Organ damage Obstructive lung disease

Infection Stroke Organ damage