The nurse caring for the client diagnosed with sickle cell crisis places priority on which specific goal(s) prior to discharge? (SELECT ALL THAT APPLY)

Decrease fluid intake of 1000 mL/day to prevent fluid overload

The client verbalizes the procedure for a 24-hour urine collection

Oxygenation and perfusion to meet cellular and metabolic needs

Complications are prevented or minimized

Pain is relieved or controlled

Answer and Explanation

Correct Answer : C,D,E

A. Decrease fluid intake of 1000 mL/day to prevent fluid overload: This goal is not appropriate. Clients with sickle cell crisis often require increased fluid intake to prevent dehydration and promote circulation, so limiting fluids is counterproductive.

B. The client verbalizes the procedure for a 24-hour urine collection: While understanding this procedure may be relevant for monitoring kidney function or hydration status, it is not a priority goal directly related to managing sickle cell crisis.
C. Oxygenation and perfusion to meet cellular and metabolic needs: Ensuring adequate oxygenation and perfusion is crucial in managing sickle cell crisis, as compromised blood flow can exacerbate pain and lead to further complications.

D. Complications are prevented or minimized: Preventing complications, such as infections or acute chest syndrome, is a key goal in managing a client with sickle cell disease, making this a critical aspect of discharge planning.

E. Pain is relieved or controlled: Pain management is a primary focus during a sickle cell crisis. Ensuring that pain is effectively managed before discharge is essential for the client's comfort and overall well-being.

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Correct Answer is D

Explanation

A. Administer the medications at different times to provide an even blood level: This option is inappropriate given the client's current heart rate. Both atenolol and diltiazem are cardiovascular medications that can further lower heart rate and potentially lead to bradycardia or other complications.

B. Assess the client's blood pressure and if the BP is normal, administer the medications: While it's important to assess blood pressure, both medications can further decrease heart rate. Given the current bradycardia (heart rate of 45 beats/min), administering either medication could exacerbate the issue.

C. Document the pulse rate and administer the medications as prescribed: This option is not appropriate. The pulse rate of 45 beats/minute is significantly below the normal range, and administering medications that can lower heart rate further could pose serious risks.

D. Withhold the medications and reassess the heart rate in 30 minutes: This is the best nursing action. Withholding the medications allows for further evaluation of the client's heart rate, and it ensures that the nurse can prevent potential adverse effects related to the bradycardia.

A. Neutrophils 57% B. International Normalized Ratio 13 seconds C. Total reticulocyte count 2.2 9% of total RBC count D. Platelet count 250.000 uL

Correct Answer is C

Explanation

A. Neutrophils 57%: This value reflects the percentage of neutrophils in the white blood cell count and does not specifically indicate the effectiveness of iron therapy. It is more related to the body’s immune response.

B. International Normalized Ratio (INR) 13 seconds: INR is a measure of blood coagulation and is not directly related to iron levels or the treatment of anemia. Therefore, this result does not indicate the success of ferrous sulfate therapy.

C. Total reticulocyte count 2.2% of total RBC count: An increased reticulocyte count indicates that the bone marrow is producing more red blood cells, which is a positive response to iron supplementation. A reticulocyte count around this percentage suggests an appropriate response to therapy for iron deficiency anemia.

D. Platelet count 250,000/µL: This is a normal platelet count and does not provide information specific to the effectiveness of iron therapy. It does not reflect the state of anemia or the response to iron supplementation.

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The nurse caring for the client diagnosed with sickle cell crisis places priority on which specific goal(s) prior to discharge? (SELECT ALL THAT APPLY)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is scheduled to receive atenolol 25 mg PO and diltiazem 60 mg PO at 0800. The nurse assesses the client's heart rate as 45 beats/minute and irregular. What is the best nursing action at this time?

Correct Answer is D

Explanation

A client has recently started ferrous sulfate 500 mg by mouth two times per day for anemia. Which of the following data would indicate to the nurse that the therapy is successful?

Correct Answer is C

Explanation

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