A nurse is caring for an adolescent who is experiencing an acute sickle cell crisis. Which of the following actions should the nurse take?
Prepare to administer a potassium IV bolus.
Provide hydration orally and IV.
Request a prescription for meperidine.
Administer multiple units of platelets.
The Correct Answer is B
Choice A reason: Preparing to administer a potassium IV bolus is not typically indicated in sickle cell crisis unless there is a documented potassium deficiency. Potassium levels must be carefully monitored to avoid hyperkalemia.
Choice B reason: Providing hydration both orally and intravenously is crucial in managing sickle cell crisis. Hydration helps to reduce blood viscosity and improve circulation, which can alleviate the pain and prevent further sickling of red blood cells.
Choice C reason: Requesting a prescription for meperidine is not recommended for pain management in sickle cell crisis due to the risk of seizures and other side effects. Other pain medications, such as morphine, are preferred.
Choice D reason: Administering multiple units of platelets is not a standard treatment for sickle cell crisis. Platelet transfusion is typically reserved for patients with thrombocytopenia or active bleeding, not for sickle cell crisis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Avoiding the removal of the cream prior to the procedure is important, but it does not specify when or how the cream should be applied, which is crucial for its effectiveness.
Choice B reason: Rubbing the cream into the skin is not recommended as it should be applied as a thick layer and covered with an occlusive dressing to ensure proper absorption and numbing effect.
Choice C reason: Applying the cream 1 hour before the procedure allows enough time for the lidocaine and prilocaine to take effect, providing adequate local anesthesia for the insertion of the IV catheter.
Choice D reason: Washing the site with alcohol prior to applying the cream is necessary to clean the area, but it is not the action that addresses the primary goal of numbing the site for the procedure.
Correct Answer is A
Explanation
Choice A reason: A blood pressure reading of 150/90 mmHg is significantly high for a 7-year-old child and indicates hypertension, which can be a serious complication of acute glomerulonephritis. It is a priority to report this finding to the provider as it may require immediate intervention.
Choice B reason: A BUN level of 20 mg/dL is within the normal range for children and is not typically a cause for immediate concern. However, it should be monitored along with other kidney function tests.
Choice C reason: Urine protein of 12 mg/dL is a common finding in acute glomerulonephritis due to increased permeability of the glomerular membrane. It is important but not as urgent as the blood pressure finding.
Choice D reason: 2+ pedal edema is a sign of fluid retention, which is expected in acute glomerulonephritis. While it should be addressed, it is not as immediately concerning as severe hypertension.
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