NUR 211 Final Questions & Answers Already Graded A+

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 B. Hematocrit: 30% C. Sodium: 147 D. WBC: 12,000 - Answer-A. Creatinine: 2.9 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 of 147, although slightly high, is not concerning A client hospitalized with sickle cell crisis frequently asks for opioid pain medications, often shortly after receiving a dose. The nurses on the unit believe the client is drug seeking. When the client requests pain medication, what action by the nurse is best? A. Give the client pain medication if it is time for another dose. B. Instruct the client not to request pain medication too early. C. Request the provider to leave a prescription for a placebo D. Tell the client it is too early to have more pain medication - Answer-A. Give the client pain medication it it is time for another dose. Clients with sickle cell crisis often have severe pain that is managed with up to 48 hours of IV opioid analgesics. Even if the client is addicted and drug seeking, he or she is still in extreme pain. If the client can receive another doe of medication, the nurse should provide it, The other options are judgmental and do not address the client's pain. Giving placebos is unethical. A client in sickle cell crisis is dehydrated and in the emergency department. The nurse plans to start an IV. Which fluid choice is best? A. 0.45% normal saline B. 0.9% normal saline C. Dextrose 50% (D50)D. Lactated Ringers solution - Answer-A. 0.45% normal saline Because clients in sickle cell crisis are often dehydrated, the fluid of choice is a hypotonic solution such as 0.45% normal saline. ).9% normal saline and lactated ringers solution are isotonic. D50 is hypertonic and not used for hydration. A client presents to the emergency department in sickle cell crisis. What intervention by the nurse takes priority? A. Administer oxygen B. Apply an oximetry probe C. Give pain medication D. Start an IV line - Answer-A. Administer oxygen All actions are appropriate, but remembering the ABCs, oxygen would come first. The main problem in a sickle cell crisis is tissue and organ hypoxia, so providing oxygen helps halt the process. A client has a sickle cell crisis with extreme lower extremity pain. What comfort measure does the nurse delegate to the UAP? A. Apply ice packs to the client's legs B. Elevate the clients legs on pillows C. Keep the lower extremities warms. D. Place elastic bandage wraps on the client's legs. - Answer-C. Keep the lower extremities warm During a sickle cell crisis, the tissue distal to the occlusion has decreased blood flow and ischemia, leading to pain. Due to decreased blood flow, the clients legs will be cool or cold. The UAP can attempt to keep the clients legs warm. Ice and elevation will further decrease perfusion. Elastic bandage wraps are not indicated and may constrict perfusion in the legs 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 awhile if you likeC. 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. - Answer-B. I can see you are upset. I can stay here with you awhile if you like. 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. A client with sickle cell disease (SCD) takes hydroxyurea (Droxia). The client presents to the clinic reporting an increase in fatigue. What laboratory result should the nurse report immediately? A. Hematocrit: 25% B. Hemoglobin: 9.2 C. Potassium: 3.2 D. WBC: 38,000 - Answer-D. WBC: 38,000