Author Question: A patient is admitted with the diagnosis of sickle-cell crisis. What should the nurse do first based ... (Read 107 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?

There used to be a metric calendar, as well as metric clocks. The metric calendar, or "French Republican Calendar" divided the year into 12 months, but each month was divided into three 10-day weeks. Each day had 10 decimal hours. Each hour had 100 decimal minutes. Due to lack of popularity, the metric clocks and calendars were ended in 1795, three years after they had been first marketed.

Did you know?

Symptoms of kidney problems include a loss of appetite, back pain (which may be sudden and intense), chills, abdominal pain, fluid retention, nausea, the urge to urinate, vomiting, and fever.

Did you know?

Thyroid conditions cause a higher risk of fibromyalgia and chronic fatigue syndrome.

Did you know?

The longest a person has survived after a heart transplant is 24 years.

Did you know?

Street names for barbiturates include reds, red devils, yellow jackets, blue heavens, Christmas trees, and rainbows. They are commonly referred to as downers.

For a complete list of videos, visit our video library