The client with sickle cell disease (SCD) has recently been sick and is now experiencing a vaso-occlusive crisis. Which priority interventions should the nurse implement?
Encourage frequent ambulation in the hallways
Monitor the client's RBC count every 4 hours
Treat them in an outpatient setting
Maintain IV fluids, administer pain medications, and provide supplemental oxygen
The Correct Answer is D
A. Encouraging frequent ambulation is not appropriate during a vaso-occlusive crisis, as it can exacerbate pain and further compromise blood flow.
B. While monitoring the RBC count is important, it is not the most immediate intervention during a crisis. The focus should be on managing pain and preventing complications.
C. Treating the client in an outpatient setting is inappropriate during a vaso-occlusive crisis, which typically requires inpatient care for effective pain management and hydration.
D. Maintaining IV fluids, administering pain medications, and providing supplemental oxygen are critical interventions that address the acute needs of the client in crisis, aiming to alleviate pain and improve oxygenation.
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Correct Answer is B
Explanation
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.
Correct Answer is B
Explanation
A. A quantitative RNA assay is used to measure the amount of HIV RNA in the blood and is not used for confirmatory diagnosis after a positive ELISA.
B. The Western blot analysis is the standard confirmatory test for HIV following a positive ELISA result, as it specifically detects the presence of antibodies to HIV proteins.
C. A viral load test assesses the level of virus in the blood but does not confirm the diagnosis of HIV.
D. The CD4+ T-cell count is used to assess immune function in individuals with HIV but is not a confirmatory test for the diagnosis of the virus.