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."
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Alcohol can directly suppress the production of red blood cells (erythropoiesis) in the bone marrow, leading to anemia.
B. While alcoholics may indeed be deficient in folate due to poor nutrition, folate deficiency is not the primary mechanism for anemia in alcoholic liver disease.
C. Liver dysfunction can lead to decreased production of clotting factors, contributing to coagulopathy, but it is not the primary mechanism for anemia in alcoholic liver disease.
D. Gastric ulcers may indeed lead to chronic blood loss, contributing to anemia, but it is not specific to alcoholic liver disease.
E. While alcohol-induced inflammation may contribute to various complications, including liver damage, it is not the primary mechanism for anemia in alcoholic liver disease.
Correct Answer is D
Explanation
A. Total protein level. Total protein level does not directly indicate bone marrow suppression.
B. Serum potassium level. Serum potassium level reflects electrolyte balance but is not specific for bone marrow suppression.
C. Erythrocyte sedimentation rate (ESR). ESR can indicate inflammation but is not a reliable indicator of bone marrow suppression.
D. Platelet count. Platelet count is a reliable indicator of bone marrow suppression because chemotherapy can significantly reduce platelet production, leading to thrombocytopenia.
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