The nurse admits a patient who is in a sickle cell crisis. The nurse should prepare for which intervention as the top priority in the management of the patient?

Oxygen administration

Blood transfusion

Intravenous fluid therapy

Pain management

Answer and Explanation

The Correct Answer is D

A.   Oxygen therapy may be indicated if the patient shows signs of respiratory distress or has low oxygen saturation levels, but it does not address the underlying pain or dehydration associated with the crisis.
B.   Blood transfusions can be an effective treatment for severe complications of sickle cell disease, including acute chest syndrome or severe anemia. However, transfusions are not typically the immediate priority in the early management of a sickle cell crisis unless there is a clear indication of severe anemia or complications.
C.   IV fluid therapy is crucial for managing dehydration, which can exacerbate sickle cell crises. Adequate hydration helps reduce blood viscosity and can alleviate some symptoms. However, while important, fluid therapy alone does not address the immediate and often severe pain that patients experience.
D.   Pain management is the top priority in the management of a patient in a sickle cell crisis. Patients often experience severe pain due to vaso-occlusive events, and addressing pain is essential for patient comfort and quality of care.

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Correct Answer is B

Explanation

A. Diabetes Insipidus is primarily related to issues with the production of vasopressin (ADH) or the body's response to it, which is not directly caused by CKD. CKD may lead to fluid retention and imbalances, but it does not typically cause recurrent bouts of diabetes insipidus.
B. In CKD, the kidneys lose their ability to produce erythropoietin, a hormone that stimulates red blood cell production in the bone marrow. Patients often require erythropoiesis-stimulating agents (ESAs) like erythropoietin injections to manage anemia associated with CKD.
C. CKD patients are often hyperkalemic (high potassium levels) rather than hypokalemic. As kidney function declines, the kidneys struggle to excrete potassium, leading to elevated levels, which can cause serious complications.
D. CKD patients often experience hypocalcemia (low calcium levels) due to several factors, including decreased activation of vitamin D and imbalances in phosphate levels. While some patients may experience transient hypercalcemia due to treatments or dietary factors, chronic hypercalcemia is not typical in CKD.

A. Provide calm reassurance while reassessing blood pressure B. Administer Epinephrine 1:1.000 IM C. Place on Nasal Cannula 6 Lpm D. Raise the HOB to high fowlers

Correct Answer is B

Explanation

A. While it’s important to provide reassurance, this option does not directly address the acute symptoms of respiratory distress and hypotension. Monitoring blood pressure is essential, but immediate action to treat the underlying issue is more critical.
B. This is the priority intervention in the case of suspected anaphylaxis. Epinephrine acts quickly to counteract severe allergic reactions, relieving bronchospasm, increasing heart rate, and raising blood pressure. Given the patient's wheezing and hypotension, administering epinephrine is crucial.
C. Administering oxygen can be beneficial, especially if the patient is experiencing respiratory distress. However, it does not address the potential anaphylactic reaction or the drop in blood pressure directly. It should be part of the management but not the priority.
D. Elevating the head of the bed can help improve breathing, especially if the patient is in respiratory distress. However, this action alone does not address the potential life-threatening aspects of anaphylaxis.

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The nurse admits a patient who is in a sickle cell crisis. The nurse should prepare for which intervention as the top priority in the management of the patient?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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