A client admitted for sickle cell crisis is distraught after ...

[viki]

A client admitted for sickle cell crisis is distraught after learning her child also has the disease. What response by the nurse is best?
 
  a. Both you and the father are equally responsible for passing it on.
  b. I can see you are upset. I can stay here with you a while if you like.
  c. It's not your fault; there is no way to know who will have this disease.
  d. There are many good treatments for sickle cell disease these days.

Question 2

A nurse caring for a client with sickle cell disease (SCD) reviews the client's laboratory work. Which finding should the nurse report to the provider?
 
  a. Creatinine: 2.9 mg/dL
  b. Hematocrit: 30
  c. Sodium: 147 mEq/L
  d. White blood cell count: 12,000/mm3

[mjbamaung]

Answer to Question 1

ANS: B
The best response is for the nurse to offer self, a therapeutic communication technique that uses presence. Attempting to assign blame to both parents will not help the client feel better. There is genetic testing available, so it is inaccurate to state there is no way to know who will have the disease. Stating that good treatments exist belittles the client's feelings.

Answer to Question 2

ANS: A
An elevated creatinine indicates kidney damage, which occurs in SCD. A hematocrit level of 30 is an expected finding, as is a slightly elevated white blood cell count. A sodium level of 147 mEq/L, although slightly high, is not concerning.