You are caring for a patient who has Sickle Cell Disease (SCD) who is in the hospital for an acute worsening of their disease. Your patient is receiving ATC opioids for their severe pain, when they suddenly report a new sharp pain in their left shoulder. What is your BEST action?

Call the MD to report a potential Emergency

Call the MD to request a X-ray of the shoulder

Perform a head to toe assessment and then chart your findings

Call the MD to request an increase to their opioid dosage

Answer and Explanation

The Correct Answer is A

A.   A sudden new pain in a patient with SCD can be a sign of a serious complication, such as acute chest syndrome or stroke. Prompt medical evaluation is crucial to identify and address any underlying complications.
B.   While an X-ray may be helpful to rule out other causes of shoulder pain, it is not the most urgent priority in this case. The patient's sudden onset of pain could be a sign of a serious complication that requires immediate attention.
C.   While a head-to-toe assessment is important for any patient, it is not the most urgent priority in this case. The patient's new pain could be a sign of a serious complication that requires immediate medical attention.
D.   Increasing the opioid dosage may provide temporary relief from the pain, but it does not address the underlying cause of the new pain.

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Correct Answer is A

Explanation

A. This statement indicates a good understanding of nutritional needs. High-protein foods are essential for maintaining muscle mass and supporting immune function, particularly for individuals with HIV. Finger foods can also help if the client has a reduced appetite or difficulty with larger meals.
B. While hydration is important, 1 liter may not be sufficient for overall health, especially if the client is experiencing weight loss or other symptoms of dehydration. The nurse would typically recommend a higher intake, considering fluid needs can vary based on activity level and overall health.
C. This statement may not be optimal for weight gain. For someone struggling with weight maintenance, smaller, more frequent meals may be more beneficial than three large meals. Large meals might lead to fullness and decrease overall caloric intake, which can hinder weight gain efforts.
D. While fats can provide a high caloric density, a diet excessively high in unhealthy fats is not ideal. It’s important to focus on healthy fats (like avocados, nuts, and olive oil) rather than just increasing fat intake indiscriminately.

A. Morphine Sulfate 4 mg IV ATC B. Fentanyl 25 mcg/hr transdermal patch Now C. Ibuprofen 800 mg PO D. Hydromorphone liquid 5 mg PO

Correct Answer is A

Explanation

A. Morphine is a strong opioid analgesic that is effective for managing severe pain, especially in acute situations like a vaso-occlusive crisis. Administering it intravenously allows for rapid onset of pain relief, which is critical given the severity of the patient’s symptoms. Continuous dosing (ATC—around the clock) ensures that pain is managed effectively.
B. Fentanyl patches are typically used for chronic pain management and take time to reach effective levels in the bloodstream (up to 12 hours or longer). In the case of acute severe pain from a vaso- occlusive crisis, this option would not provide immediate relief.
C. While ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can help relieve mild to moderate pain, it is not adequate for severe pain management. Additionally, in the setting of sickle cell disease, patients may be at risk for renal issues, making high doses of NSAIDs potentially harmful.
D. Hydromorphone is also a strong opioid analgesic; however, administering it orally may not be effective for severe pain management in an acute situation. IV administration of opioids is preferred for immediate and potent pain relief during a vaso-occlusive crisis.

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You are caring for a patient who has Sickle Cell Disease (SCD) who is in the hospital for an acute worsening of their disease. Your patient is receiving ATC opioids for their severe pain, when they suddenly report a new sharp pain in their left shoulder. What is your BEST action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching for a client who has stage 2 HIV disease and is having difficulty maintaining normal weight. Which of the following statements by the client should indicate to the nurse an understanding of the teaching?

Correct Answer is A

Explanation

A patient who has sickle cell disease was admitted with a vaso-occlusive crisis and reports severe abdominal and flank pain. Which of the following analgesic medications will be MOST appropriate to administer to the patient?

Correct Answer is A

Explanation

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You are caring for a patient who has Sickle Cell Disease (SCD) who is in the hospital for an acute worsening of their disease. Your patient is receiving ATC opioids for their severe pain, when they suddenly report a new sharp pain in their left shoulder. What is your BEST action?

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