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 D
Explanation
A. Pain in the neck when the patient flexes their head towards the chest. This describes nuchal rigidity, not Kernig sign.
B. Involuntary flexion of the hips and knees when the neck is flexed. This describes Brudzinski sign, not Kernig sign.
C. Photophobia and headache triggered by bright light. These are symptoms of meningitis, but they are not specific to Kernig sign.
D. Pain and resistance when attempting to extend the patient's leg from a flexed position. A positive Kernig sign is when there is pain and resistance to leg extension from a flexed hip and knee position, indicating meningeal irritation.
Correct Answer is B
Explanation
A. Inflammation of the motor cortex leads to decreased coordination and balance. Parkinson’s disease is not caused by inflammation in the motor cortex; it primarily involves the loss of dopamine-producing neurons.
B. Degeneration of dopamine-producing neurons in the substantia nigra of the brain leads to motor dysfunction. Parkinson’s disease is caused by the degeneration of dopamine-producing neurons in the substantia nigra, leading to motor symptoms such as tremors, rigidity, and bradykinesia.
C. A loss of acetylcholine in the brain leads to memory problems and cognitive decline. While a loss of acetylcholine is associated with Alzheimer’s disease, it is not the primary issue in Parkinson’s disease.
D. Excess production of dopamine in the basal ganglia leads to tremors and muscle rigidity. In Parkinson’s disease, there is a decrease, not an excess, in dopamine production, which contributes to motor symptoms.