A child with sickle cell disease is seen in the emergency department with increasing back and leg pain for the past 2 days. What is this child most likely experiencing?
a. A vaso-occlusive crisis
b. Acute splenic sequestration
c. Erythroblastopenia
d. Acute chest syndrome
A
A vaso-occlusive crisis is the most common type of crisis and is characterized by mild to severe pain. Pain can occur anywhere, but is typically manifested as bone or joint pain. Symptoms of acute splenic sequestration are associated with blood volume pooling, causing splenic enlargement and hypovolemic shock. Symptoms of pallor, lethargy, headache, and upper respiratory infection seen in erythroblastopenia result from decreased blood cell production by the bone marrow. Chest pain, fever, and cough are characteristic of acute chest syndrome.
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Which of the following is an important step in preventing legal action against the nurse?
a. Never make a mistake. b. Deflect blame from yourself as much as possible. c. Develop caring, therapeutic relationships with patients. d. Avoid explaining care procedures to patients.
A patient has been experiencing drowsiness, confusion, and slight focal deficits for 3 days. The CT report findings are negative. The patient is being prepared for a lumbar puncture. The nurse anticipates that the CSF would appear
a. cloudy. b. bloody. c. xanthochromic. d. clear.
The nurse should recognize which as an early sign of distributive shock?
a. Hypotension b. Skin warm and flushed c. Oliguria d. Cold, clammy skin
The nurse has just begun administering intravenous streptokinase (Streptase). The nurse assesses vital signs and notes a temperature of 37° C, a heart rate of 70 beats per minute, and a blood pressure of 88/58 mm Hg
The nurse will contact the provider to a. request an adjustment of the streptokinase dose. b. request an order for aminocaproic acid (Amicar). c. request epinephrine to prevent anaphylaxis. d. report potential hemorrhage in this patient.