Which patient statement to the nurse indicates a need for additional instruction about taking oral ferrous sulfate?

Correct Answer: A

Rationale: In this scenario, option A is the correct answer. The patient stating they will call their health care provider if their stools turn black indicates a need for additional instruction about taking oral ferrous sulfate. This is because black stools are a common and harmless side effect of ferrous sulfate due to its iron content. It is important for the patient to understand that this side effect is expected and not a cause for concern. Option B is incorrect because it is a good practice for patients taking iron supplements to also take a stool softener to prevent constipation, so this statement does not indicate a need for additional instruction. Option C is incorrect because taking iron with orange juice about an hour before eating is a correct instruction for enhancing iron absorption, so this statement does not indicate a need for additional instruction. Option D is incorrect because increasing fluid and fiber intake while taking iron tablets is also a correct instruction to prevent constipation, so this statement does not indicate a need for additional instruction. Educationally, this question highlights the importance of patient education when administering medications. It emphasizes the need for nurses to provide clear instructions to patients about expected side effects and when to seek further medical advice. This helps ensure patient safety and adherence to the prescribed treatment regimen.

Correct Answer: B

Rationale: The correct answer is to evaluate the effectiveness of opioid analgesics. In sickle cell crisis, pain is the most common symptom and is usually managed with large doses of continuous opioids. Monitoring fluid intake (Choice A) is important, but limiting fluids may not be necessary. Encouraging ambulation (Choice C) is generally good but may not be the priority during a sickle cell crisis. Educating the patient about nutrition (Choice D) is important for overall health but may not be the immediate focus during a crisis.

Correct Answer: D

Rationale: The correct answer is option D: "Risk for a crisis is decreased by having an annual influenza vaccination." This statement indicates a good understanding of preventing sickle cell crisis because individuals with sickle cell disease are at an increased risk of infections, including influenza. Vaccinations, such as the annual influenza vaccine, help prevent infections, which can trigger a sickle cell crisis. By staying up-to-date on vaccinations, patients can reduce their risk of experiencing a crisis. Option A is incorrect because while oxygen therapy can be used during a sickle cell crisis to improve oxygenation, it is not a preventive measure. Option B is incorrect as there are medications, such as hydroxyurea, that can help prevent sickling and reduce the frequency of crises. Option C is incorrect because routine continuous dosage narcotics are not typically prescribed to prevent a crisis; they are more commonly used to manage pain during a crisis. In the context of medical surgical nursing, it is crucial for nurses to educate patients with sickle cell disease on preventive measures to reduce the frequency and severity of crises. Vaccinations, medication adherence, hydration, and avoiding triggers are essential components of managing sickle cell disease effectively. By understanding these preventive strategies, patients can take an active role in their health and well-being.

Correct Answer: C

Rationale: The correct answer is C: 'Avoid exposure to crowds when possible.' This instruction is crucial in discharge teaching for a patient admitted with a sickle cell crisis because exposure to crowds increases the risk of infection, which is the most common cause of sickle cell crisis. Choices A, B, and D are incorrect. Taking a daily multivitamin with iron (Choice A) may be beneficial for some individuals but is not specifically related to managing sickle cell crisis. Limiting fluids to 2 to 3 quarts per day (Choice B) is not typically recommended for patients with sickle cell crisis, as adequate hydration is important. Drinking only two caffeinated beverages daily (Choice D) is not a priority instruction in managing sickle cell crisis.

Correct Answer: B

Rationale: The correct answer is B: bilirubin level. Jaundice, characterized by scleral jaundice, is caused by the elevation of bilirubin levels associated with red blood cell hemolysis. Checking the bilirubin level in the laboratory results will help assess the severity of jaundice in the patient. Choices A, C, and D are incorrect because the Schilling test is used to assess vitamin B12 absorption, gastric analysis is used to evaluate gastric function, and stool occult blood is used to detect hidden blood in the stool, which are not directly related to evaluating jaundice in a patient with hemolytic anemia.