TJ, a 30-year-old client is admitted in sickle cell crisis with symptoms of dyspnea and leg pain. TJ's significant other asks, "I don't really understand why he is hurting so badly." Which of the following responses by the nurse is best?

"Clumping of abnormal red blood cells blocks the flow of blood through the capillaries."

"Bleeding in the joints occurs because red blood cells are being rapidly destroyed by the bone marrow."

"The pain is due to a disturbance in cellular metabolism."

"The bone marrow is expanding with the sickled cells and that causes pain."

Answer and Explanation

The Correct Answer is A

A.   This response accurately describes the pathophysiology of sickle cell crisis. During a crisis, sickled red blood cells clump together, leading to microvascular occlusion and impaired blood flow to tissues, resulting in pain.
B.   Bleeding in the joints is not a characteristic feature of sickle cell crisis. It may occur in other conditions such as hemophilia or osteoarthritis but not in sickle cell crisis.
C.   Disturbance in cellular metabolism is not the primary mechanism underlying the pain experienced during sickle cell crisis.
D.   Bone marrow expansion with sickled cells may contribute to bone pain in sickle cell disease, but it is not the primary cause of pain during a sickle cell crisis.

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Correct Answer is A

Explanation

A. Given the low hemoglobin level and weight, the patient is likely experiencing fatigue due to decreased oxygen-carrying capacity of the blood, leading to activity intolerance.
B. While weight loss may contribute to body image disturbance, it is not the primary concern for a patient with iron-deficiency anemia and low hemoglobin levels.
C. Anxiety related to the hospital environment may be present, but it is not the most appropriate nursing diagnosis based on the patient's clinical presentation and laboratory findings.
D. Impaired tissue integrity related to immobility is not the most appropriate nursing diagnosis for a patient with iron-deficiency anemia. This diagnosis is more commonly associated with pressure ulcers or skin breakdown in patients who are immobile for extended periods, which is not described in this scenario.

A. Risk for Injury related to increased bleeding tendency B. Risk for Infection related to decreased antibody production C. Decreased Cardiac Output related to hypovolemia D. Impaired Gas Exchange related to decreased oxygen-carrying capacity

Correct Answer is A

Explanation

A. Inadequate production of platelets results in an increased risk of bleeding, making the client vulnerable to injury. Therefore, the priority nursing diagnosis is "Risk for Injury related to increased bleeding tendency."
B. Decreased antibody production is not directly related to inadequate platelet production.
C. While decreased platelet production may contribute to hypovolemia in some cases, the primary concern is the risk of bleeding rather than decreased cardiac output.
D. Impaired gas exchange is not directly related to inadequate platelet production.

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TJ, a 30-year-old client is admitted in sickle cell crisis with symptoms of dyspnea and leg pain. TJ's significant other asks, "I don't really understand why he is hurting so badly." Which of the following responses by the nurse is best?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In helping prepare a nursing care plan for a 90-pound, 82-year-old woman with iron-deficiency anemia with a hemoglobin of 8.2, the nurse agrees that the most appropriate nursing diagnosis would be:

Correct Answer is A

Explanation

What is the priority nursing diagnosis for a client with inadequate production of platelets?

Correct Answer is A

Explanation

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