A nurse is caring for an adolescent who has sickle-cell anemia. Which of the following manifestations indicates acute chest syndrome and should be immediately reported to the provider?

Hematuria

Sneezing

Substernal retractions

Temperature 37.9° C (100.2° F)

Answer and Explanation

The Correct Answer is C

Rationale:

A. Hematuria: Blood in the urine can occur with sickle cell disease due to renal papillary necrosis, but it is not specific to acute chest syndrome and does not require immediate emergency action in this context.

B. Sneezing: Sneezing is typically associated with upper respiratory infections or allergies and is not indicative of acute chest syndrome. It is not a critical symptom in this scenario.

C. Substernal retractions: Substernal retractions are a sign of respiratory distress and can indicate acute chest syndrome a life-threatening complication of sickle cell anemia. It involves pulmonary infiltration and can rapidly progress to hypoxia and respiratory failure, requiring urgent intervention.

D. Temperature 37.9° C (100.2° F): While fever in a sickle cell client should be closely monitored and reported, this temperature is low-grade. Alone, it does not immediately signal acute chest syndrome without accompanying respiratory symptoms.

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Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"B"},"C":{"answers":"A,B"},"D":{"answers":"B"}}

Explanation

Rationale:

Platelet count: A low platelet count (<100,000/mm³) is a hallmark of HELLP syndrome but can also appear in severe preeclampsia. Therefore, thrombocytopenia supports both diagnoses.
Alanine aminotransferase (ALT): Elevated ALT indicates hepatic involvement due to hepatocellular injury, which is a defining feature of HELLP syndrome but not required for preeclampsia diagnosis.
Blood pressure: Severe hypertension (≥160/110 mm Hg), as seen in this client, is diagnostic of severe preeclampsia. It may also be present in HELLP syndrome due to overlapping pathophysiology.
Hemoglobin: Low hemoglobin can reflect hemolysis, which is part of the HELLP acronym (Hemolysis, Elevated Liver enzymes, Low Platelets). Preeclampsia does not typically present with anemia unless HELLP develops.

A. Maternal diabetes B. Prematurity C. Hypothermia D. Thrombocytopenia E. Anemia

Correct Answer is ["A","B","C"]

Explanation

Rationale:

A. Maternal diabetes: Infants born to diabetic mothers are at increased risk for hypoglycemia due to elevated insulin levels stimulated by maternal hyperglycemia. After birth, the abrupt loss of maternal glucose can lead to a rapid drop in the infant’s blood sugar.

B. Prematurity: Premature infants have limited glycogen stores and immature metabolic systems, making them more susceptible to hypoglycemia. Their inability to effectively regulate glucose levels increases their risk after birth.

C. Hypothermia: Cold stress increases metabolic demands and glucose consumption. As the infant uses more energy to maintain body temperature, blood glucose levels can drop rapidly if not closely monitored and managed.

D. Thrombocytopenia: Low platelet counts may indicate other underlying conditions but are not directly associated with hypoglycemia. It is more relevant to clotting and bleeding risks rather than glucose regulation.

E. Anemia: Anemia affects oxygen-carrying capacity but does not have a direct link to blood glucose control. While it may indicate other health issues, it is not a recognized independent risk factor for neonatal hypoglycemia.

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A nurse is caring for an adolescent who has sickle-cell anemia. Which of the following manifestations indicates acute chest syndrome and should be immediately reported to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is continuing to care for the client. Exhibits The nurse is reviewing the assessment findings. For each assessment finding, click to specify if the finding is consistent with preeclampsia or HELLP syndrome. Each finding may support more than one disease process.

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"B"},"C":{"answers":"A,B"},"D":{"answers":"B"}}

Explanation

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Correct Answer is ["A","B","C"]

Explanation

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