The nurse admits a patient who is in a sickle cell crisis. The nurse should prepare for which intervention as the top priority in the management of the patient?

Oxygen administration

Blood transfusion

Intravenous fluid therapy

Pain management

Answer and Explanation

The Correct Answer is D

A.   Oxygen therapy may be indicated if the patient shows signs of respiratory distress or has low oxygen saturation levels, but it does not address the underlying pain or dehydration associated with the crisis.
B.   Blood transfusions can be an effective treatment for severe complications of sickle cell disease, including acute chest syndrome or severe anemia. However, transfusions are not typically the immediate priority in the early management of a sickle cell crisis unless there is a clear indication of severe anemia or complications.
C.   IV fluid therapy is crucial for managing dehydration, which can exacerbate sickle cell crises. Adequate hydration helps reduce blood viscosity and can alleviate some symptoms. However, while important, fluid therapy alone does not address the immediate and often severe pain that patients experience.
D.   Pain management is the top priority in the management of a patient in a sickle cell crisis. Patients often experience severe pain due to vaso-occlusive events, and addressing pain is essential for patient comfort and quality of care.

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Correct Answer is D

Explanation

A. Timolol is a beta-blocker used primarily to treat glaucoma by reducing intraocular pressure. It would not address the issues presented by this patient, who is likely dealing with alcohol-related complications.
B. Acetaminophen is used to relieve pain and reduce fever. While the patient reports a severe headache, administering acetaminophen may not be advisable due to potential liver damage from alcohol use, especially if the patient has not eaten properly. Chronic alcohol use can also increase the risk of hepatotoxicity with acetaminophen.
C. Aspirin is another pain reliever that could potentially be used for headaches. However, like acetaminophen, it carries risks for patients with alcohol use, particularly gastrointestinal bleeding. Additionally, aspirin should be used cautiously in cases of possible liver impairment.
D. A "banana bag" is a term for an intravenous solution often used in patients with alcohol use disorder to provide hydration and essential vitamins, especially thiamine, which can prevent Wernicke's encephalopathy. It typically contains normal saline or dextrose, electrolytes, and vitamins (including B1, B6, and B12).

A. Hgb of less than 11 B. aPTT of 120 seconds C. Hgb of more than 11 D. PT/INR of 3.5

Correct Answer is C

Explanation

A. Epoetin Alfa is typically used to treat anemia, and it is often indicated when hemoglobin (Hgb) levels are below 11 g/dL. Therefore, if the Hgb is less than 11, it would be appropriate to administer the medication to help increase red blood cell production.
B. Do not hold. An activated partial thromboplastin time (aPTT) of 120 seconds indicates a prolonged coagulation time, which increases the risk of bleeding. However, Epoetin Alfa does not have a direct impact on coagulation, so this value alone would not warrant holding the medication.
C. Epoetin Alfa is generally not indicated if the Hgb level is already above 11 g/dL, particularly if there’s a risk of increasing the Hgb above the recommended therapeutic range (often above 12 g/dL). If the Hgb exceeds this level, the medication should be held to prevent complications such as thromboembolic events.
D. A PT/INR of 3.5 indicates a significantly prolonged prothrombin time, suggesting a high risk of bleeding. However, Epoetin Alfa does not directly cause bleeding.

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The nurse admits a patient who is in a sickle cell crisis. The nurse should prepare for which intervention as the top priority in the management of the patient?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Your cancer patient has bone marrow suppression from their chemotherapy treatments, and is scheduled to receive Epoetin Alfa shots 3 times per week. Which of the following lab values would cause you to hold the administration of the medication for safety concerns?

Correct Answer is C

Explanation

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