A nurse is conducting an assessment of a patient with sickle cell disease who presents with severe pain in the joints and abdomen.
The nurse observes the patient wincing in pain and states, "I feel a sharp, stabbing pain in my abdomen and my joints ache terribly.”.
What is the most likely clinical manifestation of sickle cell disease that the nurse is assessing in this patient?

Impaired immune function.

Organ damage.

Painful vaso-occlusive crisis.

Delayed growth and development.

Answer and Explanation

The Correct Answer is C

Painful vaso-occlusive crisis.

Choice A rationale:

Impaired immune function is not the primary clinical manifestation assessed in a client with sickle cell disease experiencing severe pain in the joints and abdomen.

While sickle cell disease can affect the immune system, the immediate concern in this scenario is addressing the intense pain caused by vaso-occlusion.

Choice B rationale:

Organ damage is a potential long-term complication of sickle cell disease, but it is not the primary clinical manifestation being assessed in this patient.

The description of sharp, stabbing pain in the abdomen and joint aches is indicative of a vaso-occlusive crisis, and the focus should be on pain management and addressing the crisis itself.

Choice C rationale:

The nurse is most likely assessing a painful vaso-occlusive crisis in this patient.

The description of sharp, stabbing pain and joint discomfort is consistent with the pain experienced during a vaso-occlusive crisis.

These crises are a hallmark feature of sickle cell disease, characterized by the occlusion of blood vessels by sickled red blood cells, resulting in severe pain.

Choice D rationale:

Delayed growth and development are long-term consequences of sickle cell disease, primarily seen in pediatric patients.

In this scenario, the acute issue is the pain and discomfort the patient is currently experiencing, which is more indicative of a vaso-occlusive crisis.

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Correct Answer is A

Explanation

Administering pain medication as prescribed.

Choice A rationale:

Administering pain medication as prescribed is the highest priority when caring for a client experiencing a sickling crisis in sickle cell disease.

Sickle cell crises are characterized by severe pain due to vaso-occlusion, and the nurse's primary responsibility is to alleviate this pain.

Pain medication helps to relieve the suffering and improve the client's overall comfort.

It is crucial to administer medication promptly to prevent further complications and distress.

Choice B rationale:

Encouraging the client to engage in intense physical activity is not an appropriate intervention during a sickling crisis.

Physical activity can exacerbate the crisis by increasing oxygen demand, which may worsen tissue hypoxia.

It is essential to encourage rest and limit physical exertion to minimize the risk of complications.

Choice C rationale:

Keeping the room at a very low temperature is not a recommended intervention for a sickle cell crisis.

Cold temperatures can cause vasoconstriction, which may further worsen vaso-occlusion.

Maintaining a warm and comfortable environment is more suitable to help ease the client's pain and discomfort.

Choice D rationale:

Encouraging the client to smoke to relieve pain is not a safe or appropriate intervention.

Smoking can lead to vasoconstriction and worsen the client's condition.

It is essential to promote healthy behaviors and provide effective pain management rather than suggesting harmful practices like smoking.

A. Administering blood transfusions to increase the number of healthy red blood cells. B. Providing genetic counseling and education for individuals and families affected by sickle cell disease. C. Educating patients about the importance of regular follow-up appointments and adherence to prescribed treatment regimens. D. Offering oxygen therapy for patients with acute chest syndrome or respiratory distress. E. Encouraging patients to engage in high-intensity physical activities to improve overall health.

Correct Answer is ["B","C","D"]

Explanation

Choice A rationale:

Administering blood transfusions to increase the number of healthy red blood cells.

This choice is not appropriate for the management of sickle cell disease because blood transfusions are typically reserved for specific situations, such as severe anemia, acute complications, or in patients with frequent vaso-occlusive crises.

It is not a routine intervention for all patients with sickle cell disease.

Choice B rationale:

Providing genetic counseling and education for individuals and families affected by sickle cell disease.

Genetic counseling and education are essential for patients and families affected by sickle cell disease.

This helps individuals understand the inheritance pattern, make informed family planning decisions, and manage the emotional and psychological aspects of living with a genetic disorder.

Education can also include information on preventive measures.

Choice C rationale:

Educating patients about the importance of regular follow-up appointments and adherence to prescribed treatment regimens.

Regular follow-up appointments and adherence to prescribed treatment regimens are crucial in managing sickle cell disease.

Patients need ongoing monitoring and support to detect complications early, manage pain, and optimize their overall health.

Non-adherence can lead to exacerbations and complications.

Choice D rationale:

Offering oxygen therapy for patients with acute chest syndrome or respiratory distress.

Oxygen therapy is vital for patients with sickle cell disease, especially when they experience acute chest syndrome or respiratory distress.

This intervention helps improve oxygenation, alleviate respiratory distress, and prevent further complications.

Adequate oxygenation is essential to minimize tissue damage and support the body during these acute events.

Choice E rationale:

Encouraging patients to engage in high-intensity physical activities to improve overall health.

Encouraging high-intensity physical activities is not appropriate for patients with sickle cell disease, as it can trigger vaso-occlusive crises and increase the risk of complications.

Patients with sickle cell disease are typically advised to engage in moderate, low-impact physical activities to maintain their health without exacerbating their condition.

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Naxlex Comprehensive Predictor Exams

A client with sickle cell disease is experiencing a sickling crisis.What interventions should the nurse prioritize when providing care for this client?

Correct Answer is A

Explanation

(Select All That Apply).A nurse is collaborating with a healthcare team to develop an individualized care plan for a patient with sickle cell disease.Which interventions are appropriate for the nurse to include in the plan to manage the patient's condition? .

Correct Answer is ["B","C","D"]

Explanation

A nurse is reviewing the medical history of a child diagnosed with sickle cell disease.The child's parent reports, "My child always looks pale and gets tired very easily.”.Based on this information, which complication of sickle cell disease is the nurse most likely assessing in this patient?

(Select all that apply). A nurse is performing a comprehensive assessment of a patient with sickle cell disease. Which of the following assessments are essential for monitoring signs and symptoms related to sickle cell disease? .

A nurse is teaching a client with sickle cell disease about self-care measures.Select all the appropriate self-care strategies for this client:.

A nurse is caring for a patient with sickle cell disease and is discussing pain management strategies.The nurse states, "You may find relief by taking prescribed pain medications promptly and ensuring they are effective.”.What nursing intervention is the nurse describing?

A client diagnosed with sickle cell disease reports having pain in the chest and difficulty breathing. The client states, "I have sharp chest pain, and it hurts more when I take a deep breath.”. Which complication of sickle cell disease is the client likely experiencing?

A client with sickle cell disease asks the nurse about the effects of hemoglobin S on red blood cells.Which statement by the nurse accurately explains the pathophysiology of this condition?