A nurse is caring for a client who has sickle cell disease.

Exhibits

For each client finding, click to specify if the finding is consistent with sickle cell disease, iron deficiency anemia. or leukemia. Each finding may support more than 1 disease process.

Jaundice

Respiratory status

Ankle ulcer

Joint pain

Heart rate at 1000

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,C"},"C":{"answers":"A"},"D":{"answers":"A,C"},"E":{"answers":"A,B,C"}}

Rationale Assessment Findings Jaundice

Sickle Cell Disease: Yes. Jaundice occurs due to hemolysis of red blood cells, which is common in sickle cell disease as the sickled cells break down more rapidly than normal red blood cells.

Iron Deficiency Anemia: No. Jaundice is not a characteristic finding of iron deficiency anemia. Leukemia: No. Jaundice is not typically associated with leukemia.

Respiratory Status

Sickle Cell Disease: Yes. Clients may experience dyspnea and labored breathing due to vaso-occlusive crises, which can lead to lung involvement (acute chest syndrome).

Iron Deficiency Anemia: No. While severe anemia can lead to fatigue and shortness of breath, it does not typically cause labored breathing as a primary finding.

Leukemia: Yes. Respiratory issues can arise if leukemia causes significant bone marrow infiltration or if there is an infection due to immunosuppression.

Ankle Ulcer

Sickle Cell Disease: Yes. Chronic ulcers are common in sickle cell disease due to poor circulation and vaso-occlusive episodes.

Iron Deficiency Anemia: No. Ankle ulcers are not a characteristic finding in iron deficiency anemia. Leukemia: No. While leukemia can lead to skin issues or infections, ulcers are not a typical finding. Joint Pain

Sickle Cell Disease: Yes. Joint pain is a common symptom due to vaso-occlusive crises, where sickled cells block blood flow to the joints.

Iron Deficiency Anemia: No. Joint pain is not a common symptom of iron deficiency anemia.

Leukemia: Yes. Joint pain can occur due to leukemic infiltration of the bone marrow or as a side effect of treatments.

Heart Rate at 1000 (112/min)

Sickle Cell Disease: Yes. Tachycardia can occur in response to pain, hypoxia, or anemia due to sickle cell disease.

Iron Deficiency Anemia: Yes. Increased heart rate can occur as the body compensates for decreased hemoglobin and oxygen-carrying capacity.

Leukemia: Yes. Tachycardia can also be seen in leukemia, particularly if the patient is anemic or experiencing systemic effects of the disease.

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Correct Answer is D

Explanation

A. A white blood cell (WBC) count of 8,000/mm³ is within the normal range (typically 4,000- 11,000/mm³). This value does not indicate any immediate concern and does not need to be reported to the provider.
B. A PTT of 65 seconds is elevated, as the therapeutic range for PTT when on heparin is typically 1.5 to
2.5 times the normal range (usually around 25-35 seconds). An elevated PTT increases the risk of bleeding, and this should be reported to the provider for potential adjustment of heparin dosage or further evaluation.
C. A hematocrit of 45% is within the normal range for adult females (typically around 37-47%) and males (around 42-52%). This value does not indicate a concern that needs reporting to the provider.
D. A platelet count of 74,000/mm³ is low (thrombocytopenia), as the normal range is typically 150,000- 450,000/mm³. This finding is significant, especially in the context of heparin therapy, as low platelet counts can increase the risk of bleeding.

A. "I am using the modified feeding utensils at every meal. I still spill, but I'm getting better." B. "I have all the equipment to take a shower, but I prefer a bed bath, because it is easier." C. "My wife tries to get me to go to the grocery store. but I don't like to go out much." D. "My greatest pleasure each day is having a few beers every day."

Correct Answer is A

Explanation

A. This statement reflects an active effort to adapt to the new circumstances. The client is utilizing adaptive equipment and recognizing their progress, even if there are still challenges. This shows resilience and a willingness to engage in self-care, indicating positive adaptation.
B. While this statement indicates the client has the necessary equipment, preferring a bed bath suggests a lack of willingness to engage with the shower setup. This may reflect resistance to trying new methods of independence, indicating less adaptation to the home environment.
C. This statement suggests the client is avoiding social interactions and activities outside the home. It indicates a level of withdrawal and a possible struggle with adjustment, rather than an adaptation to their new lifestyle.
D. This statement does not necessarily reflect healthy adaptation. While enjoying life is important, reliance on alcohol for pleasure may suggest avoidance of other coping mechanisms or activities that could promote better adaptation. It may indicate an unhealthy adjustment to their situation.

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A nurse is caring for a client who has sickle cell disease. Exhibits For each client finding, click to specify if the finding is consistent with sickle cell disease, iron deficiency anemia. or leukemia. Each finding may support more than 1 disease process.

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Correct Answer is D

Explanation

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Explanation

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A nurse is caring for a client who has sickle cell disease.

Exhibits

For each client finding, click to specify if the finding is consistent with sickle cell disease, iron deficiency anemia. or leukemia. Each finding may support more than 1 disease process.