A patient who has sickle cell disease was admitted with a vaso-occlusive crisis and reports severe abdominal and flank pain. Which of the following analgesic medications will be MOST appropriate to administer to the patient?

Morphine Sulfate 4 mg IV ATC

Fentanyl 25 mcg/hr transdermal patch Now

Ibuprofen 800 mg PO

Hydromorphone liquid 5 mg PO

Answer and Explanation

The Correct Answer is A

A.   Morphine is a strong opioid analgesic that is effective for managing severe pain, especially in acute situations like a vaso-occlusive crisis. Administering it intravenously allows for rapid onset of pain relief, which is critical given the severity of the patient’s symptoms. Continuous dosing (ATC—around the clock) ensures that pain is managed effectively.
B.   Fentanyl patches are typically used for chronic pain management and take time to reach effective levels in the bloodstream (up to 12 hours or longer). In the case of acute severe pain from a vaso- occlusive crisis, this option would not provide immediate relief.
C.   While ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can help relieve mild to moderate pain, it is not adequate for severe pain management. Additionally, in the setting of sickle cell disease, patients may be at risk for renal issues, making high doses of NSAIDs potentially harmful.
D.   Hydromorphone is also a strong opioid analgesic; however, administering it orally may not be effective for severe pain management in an acute situation. IV administration of opioids is preferred for immediate and potent pain relief during a vaso-occlusive crisis.

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Correct Answer is A

Explanation

A. Patients with this condition cannot absorb vitamin B12 from food due to a lack of intrinsic factor, which is essential for vitamin B12 absorption in the intestines. Therefore, vitamin B12 is administered via intramuscular (IM) injection to bypass the gastrointestinal absorption issue, ensuring that the patient receives the necessary amount of this vital nutrient.
B. While iron supplements may be necessary for other types of anemia (like iron deficiency anemia), they are not the primary treatment for Pernicious Anemia. This condition is specifically related to vitamin B12 deficiency rather than iron deficiency, so iron is not a standard treatment option in this scenario.
C. Packed red blood cell (PRBC) transfusions may be used in severe cases of anemia, particularly if the patient is symptomatic or has significant fatigue or cardiovascular instability. However, this is not a direct treatment for Pernicious Anemia itself and is not routinely used as the primary management strategy.
D. Normal saline (NS) intravenous infusion may be used for hydration or to maintain fluid balance, but it does not address the underlying cause of Pernicious Anemia. It is not a treatment for the deficiency of vitamin B12.

A. Ensure that patients with AB+ blood type only receive blood from AB type donors B. Finish transfusing PRBC's within 2 hours C. Remain with the patient during the first 15 minutes of the infusion D. Double check the blood product against the patient blood band with another RN E. Prime blood tubing with normal saline (NS)

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

Explanation

A. Individuals with AB+ blood type can receive blood from any donor type (A, B, AB, or O) because they have no antibodies against A or B antigens. The safest practice is to provide the most compatible blood type, but AB+ recipients are considered universal recipients.
B. To minimize the risk of bacterial growth and transfusion reactions, packed red blood cells (PRBCs) should be transfused within 2 hours of starting the infusion. It’s important to monitor the patient closely during this time.
C. The first 15 minutes of a blood transfusion are critical for observing any immediate adverse reactions. The nurse should stay with the patient during this time to monitor vital signs and assess for any signs of a transfusion reaction.
D. A crucial safety step is to verify the blood product against the patient’s blood band with another registered nurse (RN). This helps prevent errors related to mismatched blood transfusions, which can be life-threatening.
E. Blood transfusion tubing should be primed with normal saline to ensure that the blood product flows properly and to maintain patency. Normal saline is used because it is compatible with blood products and does not cause hemolysis.

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A patient who has sickle cell disease was admitted with a vaso-occlusive crisis and reports severe abdominal and flank pain. Which of the following analgesic medications will be MOST appropriate to administer to the patient?

Nursing Test Bank

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Correct Answer is A

Explanation

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

Explanation

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