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 ["A","C","E"]
Explanation
A. A clean catch urinalysis and urine culture: A urinalysis and culture are essential to identify the presence of infection, type of bacteria, and appropriate antibiotic sensitivity.
B. Foley catheter placement: Foley catheters are not routinely indicated for suspected urinary tract infections (UTIs) unless there is an issue with urinary retention or other specific medical indication.
C. Broad-spectrum antibiotic: Initiating a broad-spectrum antibiotic may be appropriate while waiting for culture results to address infection.
D. 0.9% sodium chloride infusion at 100 ml/hr: IV fluids are not typically necessary for a UTI unless the patient is dehydrated or unable to take oral fluids.
E. WBC count: A WBC count can help assess the systemic inflammatory response and gauge the severity of the infection.
F. Blood cultures × 2: Blood cultures are generally reserved for cases where a systemic infection or sepsis is suspected, which is not indicated by this patient's symptoms alone.
Correct Answer is A
Explanation
A. Increased pulse, respirations and blood pressure with dysphagia and respiratory distress. A myasthenic crisis is characterized by severe muscle weakness that can lead to respiratory failure, dysphagia, and increased vital signs due to the stress of respiratory distress.
B. Hypotension, diarrhea, and increased salivation. These symptoms are more indicative of a cholinergic crisis, which is due to excess acetylcholine.
C. Bradycardia and hypothermia. Bradycardia and hypothermia are not characteristic signs of a myasthenic crisis.
D. Tachypnea and hyperactive deep tendon reflexes. While tachypnea can occur in respiratory distress, hyperactive reflexes are not typical in myasthenic crisis, as it involves neuromuscular weakness.