A patient with a history of sickle cell disease is being admitted for sickle cell crisis. Which of the following nursing diagnoses should guide the nurse when providing care for the patient?

Risk for Injury related to compromised blood volume.

Risk for Deficient Fluid Volume related to infection.

Ineffective Airway Clearance related to sickled cells.

Ineffective Tissue Perfusion related to vascular occlusion.

Answer and Explanation

The Correct Answer is D

A.   Risk for Injury related to compromised blood volume is not the most appropriate nursing diagnosis for a patient with sickle cell disease in crisis. While patients may experience anemia and blood volume loss during a crisis, the primary concern is tissue perfusion due to vascular occlusion by sickled cells.
B.   Risk for Deficient Fluid Volume related to infection is not directly related to the pathophysiology of sickle cell disease or sickle cell crisis.
C.   Ineffective Airway Clearance related to sickled cells may be a concern for patients with sickle cell disease, especially during acute chest syndrome, but it is not the primary nursing diagnosis for a patient admitted for sickle cell crisis.
D.   Ineffective Tissue Perfusion related to vascular occlusion is the most appropriate nursing diagnosis for a patient with sickle cell disease in crisis. Sickle cell crisis involves the occlusion of blood vessels by sickled cells, leading to impaired tissue perfusion and potential organ damage.

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Correct Answer is C

Explanation

A. Gastrointestinal bleeding is a common source of chronic blood loss leading to iron deficiency anemia.
B. Peptic ulcers can cause chronic gastrointestinal bleeding, contributing to iron deficiency.
C. Loss of intrinsic factor leads to vitamin B12 deficiency and pernicious anemia, not iron deficiency.
D. Genitourinary bleeding is another potential source of chronic blood loss that can result in iron deficiency anemia.

A. "Once I am able to resume sexual activity, I can use a water-based lubricant if I experience discomfort." B. "I will no longer have menstrual periods." C. "I will take a tub bath instead of a shower." D. "I should increase my intake of protein and vitamin C."

Correct Answer is C

Explanation

A. Using a water-based lubricant during sexual activity can help reduce discomfort or vaginal dryness, which may occur after a hysterectomy.
B. After a total abdominal hysterectomy, menstrual periods will cease because the uterus, and often the ovaries, are removed during the procedure.
C. Taking a tub bath instead of a shower is not recommended after a total abdominal
hysterectomy and vaginal repair. Bathing in a tub can increase the risk of infection, especially if the surgical incisions are still healing. The client should avoid submerging the surgical site in water until it has fully healed and cleared by their healthcare provider.
D. Increasing intake of protein and vitamin C can support wound healing and overall recovery after surgery. This statement indicates appropriate understanding of postoperative care.

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A patient with a history of sickle cell disease is being admitted for sickle cell crisis. Which of the following nursing diagnoses should guide the nurse when providing care for the patient?

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Naxlex Comprehensive Predictor Exams

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