A nurse is assisting with the plan of care for a client who is experiencing sickle cell crisis. Which of the following interventions should the nurse include in the plan of care?
Provide a diet that is low in protein.
Avoid administration of the influenza vaccine.
Maintain the client on bed rest.
Decrease fluid intake to 1,500 mL daily.
The Correct Answer is C
A. Provide a diet that is low in protein: This is incorrect because clients in sickle cell crisis require a well-balanced diet with adequate protein, along with increased fluid intake to help maintain hydration and reduce the risk of further complications.
B. Avoid administration of the influenza vaccine: This is incorrect because vaccination, including the influenza vaccine, is important for preventing infections that can exacerbate sickle cell crises.
C. Maintain the client on bed rest: This is correct because bed rest helps to reduce the energy expenditure and stress on the body, which can help manage pain and prevent further complications during a sickle cell crisis.
D. Decrease fluid intake to 1,500 mL daily: This is incorrect because increased fluid intake is crucial in sickle cell crisis to help prevent dehydration and promote proper blood flow, thereby reducing the risk of vaso-occlusive episodes.
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Related Questions
Correct Answer is D
Explanation
A. "My provider might prescribe a glucocorticoid regimen to decrease my risk for a stroke": This is incorrect as glucocorticoids are not typically used to reduce stroke risk; they are more commonly used to manage inflammation and other conditions.
B. "Having a total cholesterol level below 200 mg/dL increases my risk for a stroke": This is incorrect because having a total cholesterol level below 200 mg/dL is generally considered desirable and lowers the risk of stroke.
C. "My risk for a stroke increases if my HbA1c level is 6 percent or less": This is incorrect because an HbA1c level of 6 percent or less is generally considered well-managed for diabetes and does not increase stroke risk; higher levels are more concerning.
D. "I can decrease my risk for a stroke by losing excess weight": This is correct as losing excess weight can reduce the risk of stroke by improving overall cardiovascular health and managing diabetes.
Correct Answer is A
Explanation
A. Increase the IV flow rate: This is correct as the client’s low blood pressure could indicate hypovolemia. Increasing the IV flow rate can help improve blood volume and blood pressure, addressing a potential cause of hypotension.
B. Cover the client with a warm blanket: While this could help if the client is hypothermic, it does not address the immediate issue of low blood pressure.
C. Compare the reading to the preoperative value: While this can provide context, it does not directly address the current low blood pressure situation.
D. Reassure the client: Reassuring the client is important but does not address the urgent issue of low blood pressure.
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