Author Question: A patient is admitted with the diagnosis of sickle-cell crisis. What should the nurse do first based ... (Read 106 times)

elizabeth18

  • Hero Member
  • *****
  • Posts: 559
A patient is admitted with the diagnosis of sickle-cell crisis. What should the nurse do first based on these clinical findings: temperature 102F, O2 saturation 89, and complaints of severe abdominal pain?
 
  1. give Tylenol (acetaminophen) grains X (650 mg)
  2. administer oxygen as prescribed
  3. administer morphine sulfate grain IM
  4. assess and document peripheral pulses

Question 2

After several doses of chemotherapy, a patient complains of fatigue, pallor, progressive weakness, exertional dyspnea, headache, and tachycardia. Which problem should the nurse identify as a priority for this patient?
 
  1. change in nutritional status
  2. difficulty with activity
  3. feeling unable to control the disease process
  4. psychosocial issues dealing with the disease process



Mollythedog

  • Sr. Member
  • ****
  • Posts: 340
Answer to Question 1

Correct Answer: 2
Hypoxia is often the cause of sickling crisis from the clumping of damaged RBCs, which creates an obstruction and hypoxia distal to the clumping. Administering oxygen will improve the pain and increase the oxygen saturation of body tissues. Applying the oxygen should be the nurse's first action. Although the temperature is elevated and will increase oxygen demands in the body by increased basal metabolic activity, this is not the first action the nurse should take, because sickling crisis is caused by oxygen deprivation in tissues, not by the fever. Morphine sulfate is a narcotic for pain, but it should be given after another intervention to address the hypoxia present in sickle-cell crisis. A full-body assessment, including peripheral pulses, is important to identify the location of the potential obstruction, but this is secondary to treating the hypoxia that is known to be present in sickle-cell crisis.

Answer to Question 2

Correct Answer: 2
Fatigue, pallor, weakness, dyspnea with activity, headache and tachycardia would cause difficulty with activity. Nutritional or iron deficiency is not the cause of the symptoms, which are related to tissue hypoxia. These manifestations do not indicate that the patient feels unable to control the disease process. Although the patient might be having coping issues, the physical symptoms are the greatest complaints; therefore, coping is not the top priority in planning care. Physiological needs must be met prior to self-actualization needs.



Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
 

Did you know?

Since 1988, the CDC has reported a 99% reduction in bacterial meningitis caused by Haemophilus influenzae, due to the introduction of the vaccine against it.

Did you know?

You should not take more than 1,000 mg of vitamin E per day. Doses above this amount increase the risk of bleeding problems that can lead to a stroke.

Did you know?

In the United States, congenital cytomegalovirus causes one child to become disabled almost every hour. CMV is the leading preventable viral cause of development disability in newborns. These disabilities include hearing or vision loss, and cerebral palsy.

Did you know?

Walt Disney helped combat malaria by making an animated film in 1943 called The Winged Scourge. This short film starred the seven dwarfs and taught children that mosquitos transmit malaria, which is a very bad disease. It advocated the killing of mosquitos to stop the disease.

Did you know?

There can actually be a 25-hour time difference between certain locations in the world. The International Date Line passes between the islands of Samoa and American Samoa. It is not a straight line, but "zig-zags" around various island chains. Therefore, Samoa and nearby islands have one date, while American Samoa and nearby islands are one day behind. Daylight saving time is used in some islands, but not in others—further shifting the hours out of sync with natural time.

For a complete list of videos, visit our video library