A nurse is admitting a client who has sickle cell anemia. Which of the following manifestations should the nurse expect with this condition?(Select All that Apply.)

Pain

Anxiety

Sleeplessness

Difficulty speaking

Depression

Answer and Explanation

Correct Answer : A,B,C,E

A.   Pain is one of the hallmark symptoms of sickle cell anemia, particularly during a sickle cell crisis. The sickling of red blood cells can obstruct blood flow, leading to ischemia and severe pain in various parts of the body, including the chest, abdomen, and joints.
B.   Clients with sickle cell anemia often experience anxiety, especially during pain crises or hospitalizations. The uncertainty surrounding pain episodes, potential complications, and the chronic nature of the disease can contribute to feelings of anxiety.
C.   Many individuals with sickle cell anemia may experience sleeplessness due to pain, discomfort, or anxiety related to their condition. Pain episodes can disrupt sleep patterns, leading to fatigue and further complicating their overall health.
D.   Difficulty speaking is not a typical manifestation of sickle cell anemia. While severe complications, such as stroke, can occur in individuals with sickle cell disease and may lead to speech difficulties, this is not a direct manifestation of the condition itself.
E.   Depression is common among individuals with chronic illnesses, including sickle cell anemia. The ongoing challenges of managing pain, frequent medical visits, and the impact of the disease on daily life can contribute to feelings of depression.

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Correct Answer is C

Explanation

A. While monitoring temperature is important in assessing for infection, it is not the priority assessment before administering morphine. Temperature does not directly relate to the immediate effects or risks associated with opioid administration.
B. Blood pressure monitoring is essential, especially in a postoperative patient. However, opioids primarily impact the respiratory system rather than directly causing significant changes in blood pressure. While hypotension can occur with opioids, it is not the most immediate concern when administering morphine.
C. This is the priority assessment. Opioids, including morphine, can cause respiratory depression, which is a serious and potentially life-threatening side effect. Before administering morphine, it is crucial to assess the respiratory rate to ensure the patient is not at risk for respiratory distress. If the respiratory rate is low (typically less than 12 breaths per minute), the nurse may need to hold the medication and notify the healthcare provider.
D. While it is important to monitor heart rate, especially in postoperative patients, the primary concern with morphine administration is its effect on respiration. The heart rate may not be as critical to assess immediately before administering morphine as the respiratory rate is.

A. worsening anemia B. vasoocclusive pain C. gastrointestinal upset D. itching/hives

Correct Answer is A

Explanation

A. This side effect, known as myelosuppression, is a significant concern and can manifest as anemia.
B. Hydroxyurea is actually prescribed to reduce the frequency of vasoocclusive crises by increasing fetal hemoglobin levels, which helps to prevent sickling of red blood cells. While a patient might experience pain crises while on hydroxyurea, the medication is intended to help manage this issue rather than be a reason for discontinuation.
C. While gastrointestinal upset is also a possible side effect, the risk of severe blood-related complications typically takes precedence when considering the discontinuation of hydroxyurea
D. While allergic reactions like itching or hives can occur with many medications, they are less common with hydroxyurea specifically.

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A nurse is admitting a client who has sickle cell anemia. Which of the following manifestations should the nurse expect with this condition?(Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is postoperative following abdominal surgery and reports incisional pain. The surgeon has prescribed morphine 4 mg IV bolus every 6 hr as needed. Before administering this medication, the nurse should complete which priority assessment?

Correct Answer is C

Explanation

What is the most likely reason a patient would discontinue their prescribed hydroxyurea?

Correct Answer is A

Explanation

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