The nurse is teaching a patient with sickle cell disease about strategies to prevent sickle cell crisis. The patient states, "I do not want to come to the hospital with another sickle cell crisis." What will the nurse include in this teaching? (Select All That Apply)

Receive pneumococcal and influenza vaccines.

Take oral hydroxyurea as ordered.

Avoid becoming dehydrated.

Follow a low-fat, low-sodium diet.

Answer and Explanation

Correct Answer : A,B,C

Choice A reason: Receiving pneumococcal and influenza vaccines is crucial for patients with sickle cell disease. Infections can trigger sickle cell crises, and these vaccines help prevent common infections that could lead to complications. Ensuring immunization against these diseases reduces the risk of crisis and hospitalization.

Choice B reason: Taking oral hydroxyurea as ordered is an important strategy for preventing sickle cell crises. Hydroxyurea increases fetal hemoglobin levels, which reduces the occurrence of sickling in red blood cells. Adherence to this medication regimen helps reduce the frequency of painful episodes and other complications associated with sickle cell disease.

Choice C reason: Avoiding dehydration is essential for patients with sickle cell disease. Dehydration can lead to increased blood viscosity, promoting sickling of red blood cells and triggering a crisis. Staying well-hydrated helps maintain proper blood flow and reduces the risk of sickle cell-related complications.

Choice D reason: Following a low-fat, low-sodium diet is generally beneficial for overall health but is not specifically targeted at preventing sickle cell crises. While maintaining a healthy diet is important, the focus for sickle cell patients should be on hydration, infection prevention, and medication adherence.

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Correct Answer is B

Explanation

Choice A reason: Advising the patient to consume protein and carbohydrates immediately is not appropriate in this context. The presence of ketones in the urine indicates that the body is using fat for energy due to a lack of insulin. Increasing carbohydrate intake without addressing the underlying insulin deficiency can worsen hyperglycemia and ketoacidosis.

Choice B reason: Notifying the provider of the result and recommending that the patient's insulin dose be increased is the appropriate intervention. The presence of ketones in the urine indicates inadequate insulin levels, and adjusting the insulin dose can help correct the metabolic imbalance and prevent further complications such as diabetic ketoacidosis.

Choice C reason: Instructing the patient to withhold the next scheduled dose of insulin is incorrect. Insulin is essential for managing blood glucose levels and preventing ketosis in patients with type 1 diabetes. Withholding insulin can lead to severe hyperglycemia and ketoacidosis.

Choice D reason: Suggesting that the patient ask their provider to start them on metformin therapy is not appropriate for type 1 diabetes. Metformin is used primarily for type 2 diabetes and is not effective in type 1 diabetes, where insulin is required for glucose management.

A. Hypotension B. Bradycardia C. Polyphagia D. Rapid, deep respiration

Correct Answer is A

Explanation

Choice A reason: Hypotension, or low blood pressure, is a common indicator of fluid volume deficit. When a patient is dehydrated or has a significant loss of fluids, their blood volume decreases, leading to lower blood pressure. This condition requires immediate attention and management to prevent complications such as shock or organ failure. Monitoring and correcting fluid balance is crucial in managing patients with diabetic ketoacidosis, making hypotension a significant assessment finding.

Choice B reason: Bradycardia, or slow heart rate, is not typically associated with fluid volume deficit. It is more often related to other conditions such as heart block, hypothyroidism, or use of certain medications. In the context of diabetic ketoacidosis, fluid volume deficit would not manifest primarily as bradycardia.

Choice C reason: Polyphagia, or excessive hunger, is a symptom commonly associated with diabetes mellitus but does not indicate fluid volume deficit. Polyphagia results from the body's inability to use glucose properly, leading to increased hunger. It is not directly related to the patient's hydration status or fluid volume.

Choice D reason: Rapid, deep respiration, also known as Kussmaul breathing, is a compensatory mechanism in response to metabolic acidosis, a hallmark of diabetic ketoacidosis. While it is an important clinical sign, it does not specifically indicate fluid volume deficit. Kussmaul respiration occurs due to the body's attempt to expel excess carbon dioxide and correct the acid-base imbalance.

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The nurse is teaching a patient with sickle cell disease about strategies to prevent sickle cell crisis. The patient states, "I do not want to come to the hospital with another sickle cell crisis." What will the nurse include in this teaching? (Select All That Apply)

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Naxlex Comprehensive Predictor Exams

The nurse is admitting a patient with type 1 diabetes. While reviewing the patient's laboratory results, the nurse notes the presence of ketones in the urine. What intervention will the nurse implement for this patient?

Correct Answer is B

Explanation

The nurse is caring for a patient with diabetic ketoacidosis. Which assessment finding indicates to the nurse that the patient is experiencing fluid volume deficit?

Correct Answer is A

Explanation

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The nurse is teaching a patient with sickle cell disease about strategies to prevent sickle cell crisis. The patient states, "I do not want to come to the hospital with another sickle cell crisis." What will the nurse include in this teaching? (Select All That Apply)

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