The nurse is caring for a client with an exacerbation of sickle cell disease (SCD). Which finding indicates to the nurse that the client is experiencing a liver complication from this condition?

Weakness

Fatigue

Glucose intolerance

Abdominal pain

Answer and Explanation

The Correct Answer is D

Reasoning:

Choice A reason: Weakness is a general symptom in sickle cell disease due to chronic anemia and reduced oxygen delivery but is not specific to liver complications. Weakness results from systemic hypoxia or energy depletion, not localized hepatic vaso-occlusion or damage, making it less indicative.

Choice B reason: Fatigue is common in sickle cell disease due to chronic hemolysis and anemia but does not specifically indicate liver complications. It reflects reduced red blood cell oxygen-carrying capacity, not hepatic involvement, which requires more localized signs like pain to confirm organ-specific issues.

Choice C reason: Glucose intolerance is not a typical liver complication in sickle cell disease. While chronic disease may affect metabolism, liver complications in SCD involve vaso-occlusion or iron overload, not direct glucose regulation issues, making this finding less relevant to hepatic involvement in this context.

Choice D reason: Abdominal pain, particularly in the right upper quadrant, indicates a liver complication in sickle cell disease. Vaso-occlusion in hepatic vessels or iron overload from transfusions can cause hepatic ischemia or hepatomegaly, leading to pain, a specific sign of liver involvement in SCD exacerbations.

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Correct Answer is D

Explanation

Reasoning:

Choice A reason: Hyperthermia is not a primary risk in SIADH. This condition involves excessive ADH, leading to water retention and hyponatremia, not temperature dysregulation. Hyperthermia may occur in infections or neurological conditions, but it is not directly related to the fluid overload characteristic of SIADH pathophysiology.

Choice B reason: Peripheral neurovascular dysfunction is not a primary concern in SIADH. The condition causes water retention, leading to dilutional hyponatremia and potential cerebral edema, not vascular or nerve issues in the extremities. Peripheral dysfunction is more associated with conditions like diabetes mellitus or vascular disease.

Choice C reason: Ineffective airway clearance is not directly linked to SIADH. While severe hyponatremia could cause neurological symptoms like seizures, airway clearance issues are more typical in respiratory conditions. SIADH primarily affects fluid balance, leading to water overload, not mucus production or airway obstruction risks.

Choice D reason: Excess fluid volume is the primary risk in SIADH due to excessive ADH, which promotes water reabsorption in the kidneys, leading to fluid overload and dilutional hyponatremia. This can cause symptoms like edema, hypertension, and, in severe cases, cerebral edema, making it the most critical concern.

A. Hemoglobin A B. Hemoglobin S C. Hemoglobin M D. Hemoglobin F

Correct Answer is B

Explanation

Reasoning:

Choice A reason: Hemoglobin A is the normal adult hemoglobin, comprising two alpha and two beta chains. In sickle cell anemia, a mutation in the beta-globin gene produces hemoglobin S, not hemoglobin A, which does not cause sickling or the vaso-occlusive crises characteristic of the disease.

Choice B reason: Hemoglobin S is the abnormal hemoglobin in sickle cell anemia, resulting from a point mutation in the beta-globin gene. This causes red blood cells to sickle under stress, leading to hemolysis and vaso-occlusion, resulting in pain, organ damage, and the clinical features of sickle cell crises.

Choice C reason: Hemoglobin M is a rare hemoglobin variant causing methemoglobinemia, not sickle cell anemia. It results from mutations affecting heme iron, leading to cyanosis, not the sickling and vaso-occlusion seen with hemoglobin S, making it irrelevant to the client’s condition.

Choice D reason: Hemoglobin F, or fetal hemoglobin, is present in newborns and persists in small amounts in adults. In sickle cell anemia, increased hemoglobin F can reduce sickling, but it is not the cause. Hemoglobin S drives the disease’s pathophysiology, not hemoglobin F.

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The nurse is caring for a client with an exacerbation of sickle cell disease (SCD). Which finding indicates to the nurse that the client is experiencing a liver complication from this condition?

Nursing Test Bank

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Explanation

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