A nurse is providing education to a client diagnosed with sickle cell anemia. Which of the following can be anticipated will be a trigger for a sickle cell crisis?
Over-hydration
Dehydration
Non-steroidal anti-inflammatory drugs (NSAIDs)
Vaccinations
The Correct Answer is B
A. Over-hydration is not a trigger for a sickle cell crisis; in fact, adequate hydration helps prevent sickling of the cells.
B. Dehydration is a significant trigger for sickle cell crises, as it can lead to increased blood viscosity and sickling of red blood cells.
C. Non-steroidal anti-inflammatory drugs (NSAIDs) are often used to manage pain associated with sickle cell crises, but they do not trigger a crisis.
D. Vaccinations are important for preventing infections in individuals with sickle cell anemia but are not associated with triggering a sickle cell crisis.
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Correct Answer is B
Explanation
A. While deep breathing can help alleviate pain, it is not the primary cause of pain in sickle cell anemia; this response could minimize the client's experience.
B. Sickle cell anemia causes red blood cells to become rigid and shaped like a sickle, which can obstruct blood flow and lead to vaso-occlusive crises, resulting in pain.
C. Although sickle cell anemia is a genetic disorder, simply stating that the mutated gene causes increased pain is too vague and does not explain the pain mechanism adequately.
D. While anemia can contribute to fatigue and some discomfort, the pain in sickle cell anemia is primarily due to the sickling of red blood cells and subsequent blockage of blood flow, rather than just the lack of hemoglobin.
Correct Answer is ["B","C","D","E","F"]
Explanation
A. Hanging a bag of 0.9% normal saline with 5% dextrose (D5%NS) is incorrect; only normal saline (0.9% NS) should be used to prime the blood transfusion line to avoid hemolysis.
B. Verifying the client's name and blood type with a second nurse is a critical safety measure to prevent transfusion reactions and ensure the correct blood product is given.
C. Infusing the unit of blood within 4 hours is essential to reduce the risk of bacterial growth in the blood product.
D. Obtaining baseline vital signs prior to starting the transfusion is important to assess the client's condition and monitor for any changes during the transfusion.
E. Continuously monitoring the client during the first 15 minutes of the transfusion is vital for detecting any signs of a transfusion reaction promptly.
F. Inserting an 18-gauge intravenous catheter is recommended for blood transfusions as it provides a sufficient lumen to accommodate the blood flow.
G. Inserting a 22-gauge intravenous catheter is acceptable for some transfusions, but an 18-gauge is preferred for larger blood products.