Which nursing intervention is important when providing care for a patient with sickle cell crisis?
Evaluating the effectiveness of opioid analgesics
Limiting the patient's intake of oral and IV fluids
Teaching the patient about high-protein, high-calorie foods
Encouraging the patient to ambulate as much as tolerated
The Correct Answer is A
Choice A reason: Evaluating the effectiveness of opioid analgesics is crucial as pain management is a primary concern for patients experiencing a sickle cell crisis.
Choice B reason: Limiting the patient's intake of oral and IV fluids is not recommended as hydration is important for patients with sickle cell crisis to reduce blood viscosity and improve circulation.
Choice C reason: Teaching the patient about high-protein, high-calorie foods is beneficial for long-term management but is not the immediate nursing intervention during a crisis.
Choice D reason: Encouraging ambulation may be part of recovery but is not the primary intervention during an acute sickle cell crisis due to the risk of pain exacerbation.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: Nephrotoxicity causes intrinsic renal failure due to direct damage to the renal parenchyma, not pre-renal failure.
Choice B reason: Acute tubular necrosis is a type of intrinsic renal failure resulting from damage to the renal tubules, not pre-renal failure.
Choice C reason: Hypovolemia is a common cause of pre-renal failure due to decreased blood flow to the kidneys, leading to reduced urine output.
Choice D reason: Acute Glomerulonephritis is an intrinsic renal condition that affects the glomeruli, not a pre-renal cause.
Correct Answer is D
Explanation
Choice A reason: While blood pressure is important, hyperkalemia can cause cardiac dysrhythmias, making the pulse rate the first assessment to ensure the patient's immediate safety.
Choice B reason: Temperature is not directly affected by serum potassium levels and is not the priority in hyperkalemia.
Choice C reason: Respirations are less likely to be affected immediately by hyperkalemia compared to cardiac function.
Choice D reason: A high serum potassium level can lead to life-threatening cardiac arrhythmias, so assessing the pulse rate is the most critical initial action.
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