Back "2" Basics
Sickled Red Blood Cells become rigid and take on this elongated 2-sided shape.
What is a crescent? (p696 Lewis, 2007)
A 14 year old girl has been hospitalized with Sickle Cell Anemia in vasoocclusive crisis. Which of these Nursing diagnoses should receive priority in the Nursing plan of care? -- A. Impaired social interaction -- B. Alteration in body image -- C. Pain -- D. Alteration in tissue perfusion
What is D - Alteration in tissue perfusion? http://enursebook.info/nclex-question-for-sickle-cell-anemia/
The organ most commonly infarcted by Sickle Cell Anemia, usually occuring by "2" to 4 years of age.
What is the spleen? (p697 Lewis, 2007)
A 25-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of highest priority for this client? -- A. Taking hourly blood pressures with mechanical cuff -- B. Encouraging fluid intake of at least 200mL per hour -- C. Position in high Fowler’s with knee gatch raised -- D. Administering Tylenol as ordered
What is B - Encouraging fluid intake. http://www.rnpedia.com/home/exams/nclex-exam/nclex-rn-practice-questions-7 It is important to keep the client in sickle cell crisis hydrated to prevent further sickling of the blood. Answer A is incorrect because a mechanical cuff places too much pressure on the arm. Answer C is incorrect because raising the knee gatch impedes circulation. Answer D is incorrect because Tylenol is too mild an analgesic for the client in crisis.
This is the most common infection associated with Sickle Cell Disease occuring in these "2" organs located bilaterally within the thorax.
What is pneumonia? (p697 Lewis, 2007)
4. Which of the following foods would the nurse encourage the client in sickle cell crisis to eat? -- A. Peaches -- B. Cottage cheese -- C. Popsicles -- D. Lima beans
What is C - Popsicles http://www.rnpedia.com/home/exams/nclex-exam/nclex-rn-practice-questions-7/answer-and-rationale
Hydration is important in the client with sickle cell disease to prevent thrombus formation. Popsicles, gelatin, juice, and pudding have high fluid content. The foods in peaches , cottage cheese , and lima beans do not aid in hydration and are, therefore, incorrect.
Increased blood viscosity and lack of oxygen can ultimately lead to the failure of this pair of organs.
What are the Kidneys? (p697 Lewis, 2007)
5. A newly admitted client has sickle cell crisis. The nurse is planning care based on assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 92. Which of the following interventions would be implemented first? Assume that there are orders for each intervention. -- A. Adjust the room temperature -- B. Give a bolus of IV fluids -- C. Start O2 -- D. Administer meperidine (Demerol) 75mg IV push
What is C - Start O2? http://www.rnpedia.com/home/exams/nclex-exam/nclex-rn-practice-questions-7/answer-and-rationale
The most prominent clinical manifestation of sickle cell crisis is pain. However, the pulse oximetry indicates that oxygen levels are low; thus, oxygenation takes precedence over pain relief.
Children with sickle cell anemia may begin taking the antibiotic penicillin when they're about this age to help prevent infection.
What is 2 months of age? http://www.mayoclinic.com/health/sickle-cell-anemia/DS00324/DSECTION=treatments-and-drugs
The male client with sickle cell anemia comes to the emergency room with a temperature of 101.4 F and tells the nurse that he is having a sickle cell crisis. Which diagnostic test should the nurse anticipate the emergency room doctor ordering for the client? -- A. Spinal tap. -- B. Hemoglobin electrophoresis. -- C. Sickle-turbidity test (Sickledex). -- D. Blood cultures.
What is D - Blood cultures?
The elevated temperature is the first
sign of bacteremia. Bacteremia leads to
a sickle cell crisis. Therefore, the bacteria
must be identified so the appropriate
antibiotics can be prescribed to
treat the infection. Blood cultures
assist in determining the type and
source of infection so that it can be
treated appropriately