Your patient has suspected aplastic anemia and has just returned to the unit to be cared for by you after having bone marrow biopsy done to confirm the diagnosis. Which of the following is the MOST appropriate nursing action?

Assess the patient's lower back for bleeding

Apply a heat pack to the biopsy site for comfort

Have the patient remain bedbound and NPO for 4-6 hours

Give aspirin for hip pain

Answer and Explanation

The Correct Answer is A

A.   This is a crucial action following a bone marrow biopsy, as there is a risk of bleeding at the biopsy site. Monitoring for signs of bleeding or hematoma formation is essential to prevent complications, making this a highly appropriate nursing action.
B.   While applying heat may provide comfort, it is generally not recommended immediately after a biopsy because it can increase blood flow to the area and potentially exacerbate bleeding. Thus, this action may not be appropriate right after the procedure.
C.   While some level of rest is important after a procedure, keeping the patient NPO (nothing by mouth) is unnecessary unless there are specific orders due to anesthesia or other considerations. Additionally, remaining bedbound could increase discomfort or risk of complications like deep vein thrombosis (DVT) if not warranted.
D.   Aspirin should be avoided in this scenario because it is an anticoagulant and can increase the risk of bleeding, particularly after a procedure like a bone marrow biopsy. Instead, other pain management strategies that do not affect clotting should be considered.

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Correct Answer is ["A","B","C","D"]

Explanation

A. Airplane flights can trigger a crisis due to changes in altitude and decreased oxygen levels in the cabin. The lower atmospheric pressure and reduced oxygen can contribute to sickling of red blood cells, increasing the risk of a crisis.
B. Dehydration is a significant trigger for sickle cell crises. It can lead to hemoconcentration, making the blood more viscous and promoting sickling of the red blood cells. Maintaining hydration is crucial for preventing crises.
C. Exposure to cold weather can trigger vaso-occlusive crises in sickle cell patients. Cold temperatures can cause blood vessels to constrict, reducing blood flow and increasing the likelihood of sickling and pain episodes.
D. Any illness, particularly infections, can trigger a sickle cell crisis. Infections can lead to increased metabolic demand, dehydration, and inflammatory responses, all of which can contribute to vaso- occlusion and pain.
E. While certain sensory stimuli can affect individuals with various conditions (like migraines), flashing light patterns on television are not commonly recognized triggers for a sickle cell crisis. There is no substantial evidence linking this to vaso-occlusive events in sickle cell disease.

A. Positive ANA titer B. 2+ urine protein C. Increased hemoglobin D. Increased serum T3 and T4 E. Elevated BUN

Correct Answer is ["A","B","E"]

Explanation

A. A positive antinuclear antibody (ANA) titer is a common finding in SLE. This test is often used as a screening tool for autoimmune diseases, and most patients with SLE will have a positive ANA. Therefore, this finding is expected.
B. The presence of protein in the urine (proteinuria) is indicative of kidney involvement, which can occur in SLE due to lupus nephritis. Given the client's difficulty urinating and other symptoms, this finding would be anticipated.
C. This statement is unlikely to be correct. In SLE, anemia is common due to various factors, including chronic disease, bone marrow involvement, or hemolysis. Therefore, an increased hemoglobin level would not be expected in this scenario.
D. This finding is not typically associated with SLE. SLE is primarily an autoimmune disease affecting the connective tissues, and thyroid function tests (like T3 and T4) would not show increased levels unless there is an underlying thyroid disorder. Therefore, this finding is not expected in SLE.
E. An elevated blood urea nitrogen (BUN) level may be anticipated, especially if there is kidney involvement due to lupus nephritis. Increased BUN can indicate impaired kidney function, which aligns with the client's symptoms of difficulty urinating.

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Your patient has suspected aplastic anemia and has just returned to the unit to be cared for by you after having bone marrow biopsy done to confirm the diagnosis. Which of the following is the MOST appropriate nursing action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following factors are known to commonly trigger a crisis in patients with sickle cell disease? (Select all that apply)

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Explanation

A nurse is reviewing the plan of care for a client who has systemic lupus erythematosus (SLE). The client reports fatigue, joint tenderness, swelling, and difficulty urinating. Which of the following laboratory findings should the nurse anticipate? (Select all that apply)

Correct Answer is ["A","B","E"]

Explanation

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