The mother of a teenage boy with sickle cell anemia asks the nurse why her son has such horrible pain during a sickle cell crisis. Which of the following is the best response by the nurse?

A. The symptoms indicate an acute coronary episode and should be treated as such:

The client's symptoms, including sudden midsternal chest pain unrelieved with rest and a history of coronary artery disease (CAD), strongly suggest an acute coronary event, such as a myocardial infarction (heart attack). Pale, cool skin can also be indicative of decreased perfusion due to cardiac compromise. Given these critical signs and symptoms, the nurse should interpret this as a potential cardiac emergency and initiate immediate interventions aimed at managing and stabilizing the client's condition.

B. The symptoms indicate angina and should be treated as such:

While angina can present with symptoms such as chest pain, it is typically relieved with rest or nitroglycerin. In contrast, the client in this scenario has midsternal chest pain that is not relieved with rest, which is more indicative of an acute coronary event like a myocardial infarction. Therefore, interpreting the symptoms as angina and treating them as such may not be appropriate given the severity and persistence of the chest pain.

C. Treatment should be determined pending the results of an exercise stress test:

Waiting for the results of an exercise stress test is not appropriate in this scenario, as the client's presentation suggests an acute cardiac event that requires immediate intervention. Exercise stress tests are typically used for diagnostic purposes to assess cardiovascular function under controlled conditions but are not suitable for managing acute coronary episodes or emergencies.

D. The symptoms indicate a pulmonary etiology rather than a cardiac etiology:

While some symptoms, such as shortness of breath or chest pain, can overlap between cardiac and pulmonary conditions, the client's presentation with sudden midsternal chest pain unrelieved with rest, pale cool skin, and a history of CAD strongly suggests a cardiac etiology, specifically an acute coronary event. It is essential to prioritize cardiac assessment and intervention based on the client's symptoms and medical history.

A. Take the medication with milk to increase absorption:

This statement is incorrect. Taking ferrous sulfate with milk or dairy products is not recommended as they can decrease iron absorption. It's advisable to take iron supplements with water or juice, preferably on an empty stomach or with a small amount of food.

B. Take the medication on an empty stomach:

This statement is partially correct. While taking ferrous sulfate on an empty stomach can enhance absorption, some individuals may experience gastrointestinal discomfort or irritation. Therefore, it's often recommended to take iron supplements with a small amount of food to minimize potential side effects.

C. Eat foods high in fiber while on this medication:

This statement is generally correct. Consuming foods high in fiber can help prevent constipation, which is a common side effect of iron supplements. Including fiber-rich foods in the diet, such as fruits, vegetables, whole grains, and legumes, can promote regular bowel movements.

D. Report stools that are dark in color immediately:

This statement is correct. Dark or black stools can indicate the presence of digested blood, which may occur due to iron supplementation. It's important to report such changes to the healthcare provider promptly for further evaluation.

E. Eating citrus fruit and juices are recommended with meals:

This statement is correct. Citrus fruits and juices, such as oranges, grapefruits, and lemon juice, contain vitamin C, which can enhance iron absorption. Consuming vitamin C-rich foods or drinks along with iron supplements can help improve iron uptake by the body.