A nurse is caring for a 12-year-old client who has sickle cell disease.
Complete the following sentence by using the lists of options.
The nurse should anticipate a provider prescription for
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Rationale for correct choices:
• IV hydromorphone: The child is in a vaso-occlusive crisis, where severe pain is the hallmark finding. IV opioids such as hydromorphone are the treatment of choice for rapid pain relief when pain reaches severe levels unrelieved by oral medications.
• Pain: The child reports escalating pain from 7/10 to 10/10 localized in the right knee with swelling and warmth, consistent with vaso-occlusion. Pain control is the immediate priority because inadequate management can worsen stress and sickling.
Rationale for incorrect choices:
• Fresh frozen plasma transfusion: This is not indicated in sickle cell crisis, as there is no coagulopathy or clotting factor deficiency. Plasma transfusion does not treat anemia or vaso-occlusive pain.
• Factor VIII: This therapy is specific to hemophilia A, which involves a clotting factor deficiency. It has no role in the management of sickle cell disease or vaso-occlusive crisis.
• Platelets: The child’s platelet count is elevated at 450,000/mm³, which reflects a reactive process but not a deficiency. Thrombocytopenia is not present, so platelet replacement is unnecessary.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "The obstruction will be treated with a medication called indomethacin.": Indomethacin is used to close a patent ductus arteriosus, not to correct coarctation of the aorta. In fact, for coarctation, maintaining ductal patency with prostaglandin E may be necessary until surgery is performed.
B. "The cardiologist will monitor your infant closely until they are able to receive treatment with a heart transplant.": Heart transplant is not the standard treatment for coarctation of the aorta. Most infants undergo surgical or catheter-based interventions, which are effective.
C. "Most cases resolve spontaneously without treatment by 12 months of age.": Coarctation of the aorta does not resolve on its own. Without treatment, it can lead to severe complications such as heart failure, hypertension, or even death, making timely intervention critical.
D. "Surgical repair is the recommended treatment for infants younger than 6 months old.": Surgical repair is the treatment of choice for significant coarctation in infants, especially those younger than 6 months, to relieve obstruction and prevent complications such as left ventricular dysfunction and poor systemic perfusion.
Correct Answer is C
Explanation
A. "As I get older, my sugar levels will automatically decrease.": Blood glucose control does not improve with age. In fact, hormonal changes during adolescence can make glucose management more challenging, requiring close monitoring and insulin adjustments.
B. "As long as I take my insulin, I can eat whatever I want.": Even with insulin therapy, diet management is essential in type 1 diabetes. Consuming excessive carbohydrates or unhealthy foods can lead to poor glycemic control and increase the risk of long-term complications.
C. "I will increase my food intake before I exercise.": Physical activity lowers blood glucose levels, and adolescents with type 1 diabetes are at risk for hypoglycemia during or after exercise. Increasing carbohydrate intake before exercise helps maintain stable glucose levels and prevent hypoglycemia.
D. "The blood pressure medicine I'm taking will help to keep my insulin level low.": Antihypertensive medications are not used to regulate insulin or glucose levels. They may be prescribed for other conditions, but they do not play a role in type 1 diabetes management.
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