A nurse is providing discharge teaching to a client with sickle cell disease. Which of the following instructions should the nurse include?
Drink plenty of fluids to stay well hydrated.
Limit your intake of fruits and vegetables to avoid complications.
You can stop your prescribed antibiotics once you feel better.
Take your pain medications only when you have severe pain.
The Correct Answer is A
A. Drink plenty of fluids to stay well hydrated. Hydration is crucial for clients with sickle cell disease as it helps prevent blood thickening and reduces the risk of sickling crises.
B. Limit your intake of fruits and vegetables to avoid complications. Fruits and vegetables are essential for balanced nutrition and are not contraindicated in sickle cell disease. Limiting them is unnecessary and could lead to nutritional deficiencies.
C. You can stop your prescribed antibiotics once you feel better. Antibiotics should always be completed as prescribed to fully treat any infection and prevent resistance, especially in individuals with weakened immune responses.
D. Take your pain medications only when you have severe pain. Clients with sickle cell disease should take pain medications as needed, even for mild pain, to prevent escalation of pain and a sickle cell crisis.
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Correct Answer is B
Explanation
A. The client states that they consume a high calcium diet and have had high calcium in their blood. A high calcium diet or hypercalcemia is more associated with kidney stones, not typically with pyelonephritis.
B. The client reports that they had two urinary tract infections (UTI) in the past months. Recurrent UTIs are a risk factor for pyelonephritis, as untreated or recurrent infections can ascend from the bladder to the kidneys, leading to this condition.
C. The client states that they remember their mother saying their grandma had this same genetic disease. Pyelonephritis is not typically a genetic disease but rather an infection of the kidneys, often secondary to urinary tract infections.
D. The client reports that they took a lot of ibuprofen for arthritis for many years. Long-term NSAID use can impact kidney function but does not directly cause pyelonephritis.
Correct Answer is C
Explanation
A. Deep vein thrombosis. Deep vein thrombosis typically causes constant pain, swelling, and redness and does not improve with rest.
B. Restless leg syndrome. Restless leg syndrome is characterized by an uncontrollable urge to move the legs, usually at rest, and is not associated with walking.
C. Intermittent claudication. Intermittent claudication is a common symptom of PAD where muscle pain or cramping occurs during activity and is relieved with rest due to insufficient blood flow.
D. Varicose veins. Varicose veins generally cause aching and swelling rather than pain triggered specifically by walking.