A nurse is assessing a patient with sickle cell disease (SCD)
The patient reports pain in various areas, including the chest and joints.
What other clinical manifestations of SCD should the nurse be vigilant for?
"I've been experiencing fever and chills recently.”
"I've noticed a yellowing of my skin and eyes.”
"I've been having trouble breathing and feeling weak.”
"I've had painful erections and impotence.”
The Correct Answer is D
Choice A rationale:
"I've been experiencing fever and chills recently." Fever and chills can be associated with various illnesses and infections but are not specific clinical manifestations of sickle cell disease (SCD)
The primary concern in SCD is vaso-occlusion, anemia, and pain, which should be monitored closely.
Choice B rationale:
"I've noticed a yellowing of my skin and eyes." Yellowing of the skin and eyes (jaundice) can occur in SCD due to the breakdown of hemoglobin, but it is not directly related to the pain in the chest and joints described in the question.
Choice C rationale:
"I've been having trouble breathing and feeling weak." While respiratory symptoms and weakness can occur in SCD, they are not the primary clinical manifestations associated with pain in the chest and joints.
Painful erections and impotence are more directly related to SCD complications, such as priapism, which is a medical emergency and requires prompt attention.
Choice D rationale:
"I've had painful erections and impotence." Painful erections and impotence are potential complications of sickle cell disease (SCD), particularly due to priapism, a condition where blood becomes trapped in the penis.
This can lead to severe pain and, if not treated promptly, permanent erectile dysfunction.
Therefore, the nurse should be vigilant for these clinical manifestations to address them promptly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E"]
Explanation
Choice A rationale:
Medication adherence is essential in the treatment and management of sickle cell disease (SCD)
Patients with SCD often require medications such as hydroxyurea to reduce the frequency of painful crises and other complications.
Non-adherence to medications can lead to worsened outcomes and increased morbidity.
Educating the patient and their family about the importance of taking medications as prescribed is crucial.
Choice B rationale:
Avoidance of cold and altitude is important for patients with SCD because exposure to cold temperatures and high altitudes can trigger vaso-occlusive crises.
Cold can cause red blood cells to sickle more easily, leading to pain and tissue damage.
Altitude can result in lower oxygen levels in the blood, exacerbating the risk of sickling.
Educating the patient and their family about these environmental factors and strategies to minimize exposure is essential for SCD management.
Choice E rationale:
Providing emotional support and coping strategies is a crucial component of managing SCD.
Patients with SCD often experience chronic pain, frequent hospitalizations, and a reduced quality of life.
Emotional support can help them cope with the physical and emotional challenges associated with the disease.
Teaching patients and their families how to manage stress, anxiety, and depression can improve their overall well-being.
Choice C rationale:
Blood transfusion is not a first-line treatment for all SCD patients.
It is typically reserved for specific indications, such as severe anemia or acute complications like stroke.
Stem cell transplantation (Choice D) is a potential curative treatment for some individuals with SCD, but it is not applicable to all patients due to factors like donor availability and eligibility.
Therefore, Choices C and D are not universally applicable and may not be included in the education and counseling plan for all SCD patients.
Choice D rationale:
Stem cell transplantation is not recommended as a treatment for all SCD patients.
It is considered a high-risk procedure with potential complications, and its suitability depends on factors such as patient age, disease severity, and the availability of a suitable donor.
Therefore, it is not included as a standard intervention in the education and counseling plan for all SCD patients.
Correct Answer is A
Explanation
Choice A rationale:
Sickle cell disease (SCD) is a genetic disorder caused by a mutation in the HBB gene, leading to the production of abnormal hemoglobin called hemoglobin S (HbS)
This abnormal hemoglobin causes red blood cells to become sickle-shaped when exposed to low oxygen levels, which is a hallmark of SCD.
The nurse's response accurately reflects the genetic basis of this condition.
Choice B rationale:
This choice is incorrect.
Sickle-shaped red blood cells in SCD are not the result of an autoimmune reaction.
Choice C rationale:
This choice is incorrect.
Sickle-shaped red blood cells are not caused by a viral infection.
Choice D rationale:
This choice is incorrect.
Diet and lifestyle choices do not contribute to the sickle shape of red blood cells in SCD.
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