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The mother of a teenage boy with sickle cell anemia asks the nurse why her son has such horrible pain during a sickle cell crisis. Which of the following is the best response by the nurse?

"Dehydration Is the primary reason for the pain that is experienced during a sickle cell crisis; try to increase your son's fluid intake."

"We really don't know what causes the pain that is experienced during a sickle cell crisis."

"Sickled cells get clogged in the blood vessels, preventing blood from getting to the tissues, which causes the severe pain of a crisis."

"You will need to discuss this with your doctor. I cannot explain why this pain occurs to your son."

Answer and Explanation

The Correct Answer is C

A. "Dehydration Is the primary reason for the pain that is experienced during a sickle cell crisis; try to increase your son's fluid intake."

This response is not the best choice because while dehydration can indeed exacerbate sickle cell crises and lead to complications, it is not the primary reason for the pain experienced during a sickle cell crisis. The severe pain during a crisis is primarily due to vaso-occlusion, where sickled red blood cells block blood flow in the small blood vessels, leading to tissue ischemia and pain. While adequate hydration is important in managing sickle cell disease, it alone does not address the underlying cause of the pain during a crisis.

B. "We really don't know what causes the pain that is experienced during a sickle cell crisis."

This response is not accurate and not the best choice because the medical community does understand the underlying cause of pain during a sickle cell crisis. It is primarily due to vaso-occlusion, as mentioned earlier, where sickled red blood cells block blood flow in the blood vessels.

C. "Sickled cells get clogged in the blood vessels, preventing blood from getting to the tissues, which causes the severe pain of a crisis."

This response is the best choice because it provides an accurate and clear explanation of why individuals with sickle cell anemia experience severe pain during a sickle cell crisis. It addresses the underlying mechanism of vaso-occlusion, where sickled red blood cells block blood flow in the small blood vessels, leading to tissue ischemia and severe pain.

D. "You will need to discuss this with your doctor. I cannot explain why this pain occurs to your

son."

This response is not the best choice because the nurse should be able to provide basic information about the disease and its symptoms to the mother. It's important for healthcare professionals to educate patients and their families about their condition to improve understanding and facilitate better management and coping strategies.

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Correct Answer is B

Explanation

The RR interval is 7.5 big boxes, multiplied by 10 makes it 75, rounded off is 80 beats per minute.

A. History of smoking B. Body mass index (BMI) of 20 C. History of diabetes D. Family history of coronary heart disease E. Female gender F. Age greater than 45 years for men

Correct Answer is ["A","C","D","F"]

Explanation

A. History of smoking:

Smoking is a well-established risk factor for coronary artery disease (CAD). Cigarette smoke contains harmful chemicals that damage blood vessels, promote the formation of atherosclerotic plaques, and increase the risk of blood clots, all of which can lead to CAD, heart attacks, and strokes.

B. Body mass index (BMI) of 20:

While obesity and elevated BMI are risk factors for CAD, a BMI of 20 falls within the healthy weight range for most adults. However, it's important to note that BMI alone may not fully capture an individual's overall cardiovascular risk, as factors like body composition, waist circumference, diet, and physical activity level also contribute to heart health.

C. History of diabetes:

Diabetes, especially type 2 diabetes, is a significant risk factor for CAD. Elevated blood sugar levels over time can damage blood vessels (atherosclerosis), increase inflammation, and contribute to other metabolic abnormalities that raise the risk of heart disease, including heart attacks and peripheral vascular disease.

D. Family history of coronary heart disease:

Having a family history of coronary heart disease (CHD) or premature heart attacks (before age 55 in men or before age 65 in women) increases the risk of developing CAD. Genetic factors play a role in the development of heart disease, and individuals with close relatives affected by CHD have a higher likelihood of developing similar conditions.

E. Female gender:

While gender can influence cardiovascular risk factors and presentation, being female alone is not considered a specific risk factor for CAD. However, women may have different risk profiles or risk factors compared to men, such as hormonal influences (e.g., menopause) and unique symptom presentation for heart disease.

F. Age greater than 45 years for men:

Advancing age is a significant risk factor for CAD, especially for men. Men aged 45 years and older are at increased risk compared to younger age groups due to factors such as the cumulative effects of risk factors over time, hormonal changes, and age-related changes in blood vessels and heart function.

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The mother of a teenage boy with sickle cell anemia asks the nurse why her son has such horrible pain during a sickle cell crisis. Which of the following is the best response by the nurse?

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