A client is being treated on the medical unit for a sickle cell crisis. The nurse's most recent assessment reveals an oral temperature of 100.5°F and a new onset of fine crackles on lung auscultation. What is the nurse's most appropriate action?

Liaise with the respiratory therapist and consider high flow oxygen.

Inform the primary care provider that the patient may have an infection.

Apply supplementary oxygen by nasal cannula.

Administer bronchodilators by nebulizer.

Answer and Explanation

The Correct Answer is B

A. Inform the primary care provider that the patient may have an infection:
Explanation: The presence of an elevated oral temperature and new onset of fine crackles on lung auscultation suggests a potential respiratory infection, which is a significant concern in a patient with sickle cell disease. Notifying the primary care provider allows for further evaluation and appropriate management of the infection.

B. Liaise with the respiratory therapist and consider high-flow oxygen:
Explanation: While oxygenation may be necessary, especially if the patient is experiencing respiratory distress, addressing the potential infection is the priority. Consulting with the respiratory therapist and considering high-flow oxygen can be part of the overall plan based on the primary care provider's recommendations.

C. Apply supplementary oxygen by nasal cannula:
Explanation: Providing oxygen support may be necessary, but it should be done in consultation with the primary care provider, who can guide the appropriate level of oxygen therapy based on the patient's condition.

D. Administer bronchodilators by nebulizer:
Explanation: Bronchodilators are typically used for conditions like asthma or COPD, and their use might not be the primary intervention in the context of a sickle cell crisis with signs of a potential respiratory infection. Addressing the infection takes precedence, and the primary care provider's input is essential in determining the appropriate course of action.

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Correct Answer is D

Explanation

A. It is rapidly absorbed, has a fast onset of action:
Explanation: This statement is incorrect. Glargine (Lantus) actually has a slow onset of action and a prolonged duration of action. It is formulated to provide a steady level of insulin in the body over an extended period.

B. Administer the total daily dosage in two doses:
Explanation: This is not the recommended administration for glargine. It is typically administered once daily to provide basal insulin coverage over a 24-hour period.

C. Draw up the drug first, then add regular insulin:
Explanation: Mixing glargine with other insulins is not recommended. Glargine should be administered separately to maintain its extended duration of action. It should not be mixed with other insulins in the same syringe.

D. Do not mix with other insulins:
Explanation: This is the correct statement. Glargine should not be mixed with other insulins. It should be administered alone to maintain its "peakless" basal coverage. Mixing it with other insulins could alter its pharmacokinetics and compromise its effectiveness.

A. 15 to 20 g of a fast-acting carbohydrate such as orange juice. B. I.V. bolus of dextrose 50%. C. I.M. or subcutaneous glucagon. D. 10 U of fast-acting insulin

Correct Answer is C

Explanation

A. 15 to 20 g of a fast-acting carbohydrate such as orange juice:
This is a standard and initial treatment for hypoglycemia. Fast-acting carbohydrates, like orange juice or glucose tablets, can quickly raise blood sugar levels. However, in the scenario described, the client is still conscious, and glucagon may be a more appropriate choice.

B. I.V. bolus of dextrose 50%:
Intravenous (IV) dextrose is a more aggressive intervention and is typically reserved for severe cases of hypoglycemia or for unconscious patients. It is not the first-line treatment for conscious patients.

C. I.M. or subcutaneous glucagon:
Glucagon is a hormone that raises blood sugar levels by promoting the conversion of stored glycogen in the liver to glucose. It is administered either intramuscularly (I.M.) or subcutaneously. In a conscious patient with hypoglycemia who cannot take oral carbohydrates, glucagon can be an effective and rapid way to raise blood sugar levels.

D. 10 U of fast-acting insulin:
Administering more insulin in a situation of hypoglycemia would worsen the condition. The goal in hypoglycemia is to raise blood sugar, and giving more insulin would have the opposite effect.

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A client is being treated on the medical unit for a sickle cell crisis. The nurse's most recent assessment reveals an oral temperature of 100.5°F and a new onset of fine crackles on lung auscultation. What is the nurse's most appropriate action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following should be included in the teaching plan for a patient receiving glargine (Lantus), "peakless" basal insulin?

Correct Answer is D

Explanation

The nurse is caring for a female client with type 2 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:

Correct Answer is C

Explanation

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