In caring for a pregnant woman with sickle cell anemia, the nurse ...

[KWilfred]

In caring for a pregnant woman with sickle cell anemia, the nurse is aware that signs and symptoms of sickle cell crisis include:
 
  a. Anemia. c. Fever and pain.
  b. Endometritis. d. Urinary tract infection.

Question 2

Nursing intervention for the pregnant diabetic patient is based on the knowledge that the need for insulin:
 
  a. Increases throughout pregnancy and the postpartum period.
  b. Decreases throughout pregnancy and the postpartum period.
  c. Varies depending on the stage of gestation.
  d. Should not change because the fetus produces its own insulin.

[AmberC1996]

Answer to Question 1

ANS: C
Women with sickle cell anemia have recurrent attacks (crisis) of fever and pain, most often in the abdomen, joints, and extremities. These attacks are attributed to vascular occlusion when RBCs assume the characteristic sickled shape. Crises are usually triggered by dehydration, hypoxia, or acidosis. Women with sickle cell anemia are not iron deficient. Therefore, routine iron supplementation, even that found in prenatal vitamins, should be avoided in order to prevent iron overload. Women with sickle cell trait usually are at greater risk for postpartum endometritis (uterine wall infection); however, this is not likely to occur in pregnancy and is not a sign of crisis. These women are at an increased risk for UTIs; however, this is not an indication of sickle cell crisis.

Answer to Question 2

ANS: C
Insulin needs decrease during the first trimester, when nausea, vomiting, and anorexia are a factor. They increase during the second and third trimesters, when the hormones of pregnancy create insulin resistance in maternal cells. Insulin needs increase during the second and third trimesters, when the hormones of pregnancy create insulin resistance in maternal cells. The insulin needs change throughout the different stages of pregnancy.

[KWilfred]

Gracias!

[kjohnson]

TYSM