While pain is a physiological sign of sickle cell crisis giving pain medicine is not going to treat the problem. Oxygen and IV fluids will. The elevated heart rate is still priority. If the sickle cell patient was having shortness of breath, you would see them first.[/quote']
This is not for me, it is for the person who needs to know this stuff for the NCLEX... It is important to know your patho and why sicklers show up in pain...
Maybe I didn't explain it effectively, but you filled in the blank, solidifying why you should see the sickler first. It is not the pain that is the issue - it's the ischemia. That's why you give the fluid and O2... Furthermore, the pain is due to the ischemia. It is clearly a Circulation issue. Run around telling people your patient has an alcoholic with a HR of 107(or any of the other choices) and needs immediate help. See what that will get you... eye rolls. This is a trick question... :-/
This was not a trick question. Giving the sickler pain medication is not going to solve their circulation issue. Assessing your alcoholic patient with an elevated HR is priority because it is a circulatory sign of active withdrawal which could turn ugly if he isnt assessed and treated. Holding off on pain medication for 15 minutes while you take care of patient number 1 is not going to make the sickle cell crisis worse.
This was not a trick question. Giving the sickler pain medication is not going to solve their circulation issue. Assessing your alcoholic patient with an elevated HR is priority because it is a circulatory sign of active withdrawal which could turn ugly if he isnt assessed and treated. Holding off on pain medication for 15 minutes while you take care of patient number 1 is not going to make the sickle cell crisis worse.
Ok... Go back to what I said. Not interested in continuing this, because it does not benefit me or anyone else to witness this pointless exchange. Then again, I forget where I am... To the people taking the NCLEX, good luck! You can do it!!
Ok... Go back to what I said. Not interested in continuing this, because it does not benefit me or anyone else to witness this pointless exchange. Then again, I forget where I am... To the people taking the NCLEX, good luck! You can do it!!
Are you an RN? Its not a pointless exchange. It helps people think through the question and see things the way NCLEX looks at these scenarios to help people make the right choices when it comes to NCLEX. Dont see how this exchange is pointless at all.
This was not a trick question. Giving the sickler pain medication is not going to solve their circulation issue. Assessing your alcoholic patient with an elevated HR is priority because it is a circulatory sign of active withdrawal which could turn ugly if he isnt assessed and treated. Holding off on pain medication for 15 minutes while you take care of patient number 1 is not going to make the sickle cell crisis worse.
Patient #1 is going to demand way more than 15 minutes. If you enter that room you may never leave. I stand by my answer. I see patient #3 first.
I like all this rationale/decision making going around. I find myself agreeing with every new answer. Pts 1 & 3 seem pretty much equal with all the postings being discussed.
My RN was written on papyrus - it's that old. I don't have to worry about NCLEX. But these are good mental exercises and learning opportunities for all.
Are you an RN? Its not a pointless exchange. It helps people think through the question and see things the way NCLEX looks at these scenarios to help people make the right choices when it comes to NCLEX. Dont see how this exchange is pointless at all.
I've learned to respect everyone for what they bring to the table. Yes, I am a RN and was well prepared for the NCLEX. Just to help you understand where I'm coming from, I have also taken physiology, pathology, physical assessment and pharm for prescribers - all at the master's level. Were you hoping that I was a janitor?
Yes, with a student, I would love to engage them, share information about my nclex experience and my prep leading up to the exam(and anything else I've learned)... they clearly have enough hands in this pot, and I refuse to engage condescending RNs. I'm ok sitting this one out - no issue here.
Patient #1 is going to demand way more than 15 minutes. If you enter that room you may never leave. I stand by my answer. I see patient #3 first.
I understand your (real world) logic, but in NCLEX world, you have all of the time in the world. Don't you wish you worked at NCLEX Memorial Hospital? :-)
I like all this rationale/decision making going around. I find myself agreeing with every new answer. Pts 1 & 3 seem pretty much equal with all the postings being discussed.
My RN was written on papyrus - it's that old. I don't have to worry about NCLEX. But these are good mental exercises and learning opportunities for all.
Keep 'em comin'!
amoLucia that's funny! I speak italian, by the way. Amo Lucia... is that a reference to the opera Lucia di Lamermoor??
To divobari - Lucia is the change in her name Lucy (of Mrs. Lucy Muir, the heroine of The Ghost & Mrs. Muir) as given to her by The Captain (Rex Harrison - am swooning). It's among my top favorite -est movies, that and Jane Eyre with Orson Welles (quick - the smelling salts again!).
Now second clue - guess what my favorite -est old time TV show is? It debuted in 10/1951 with a crazy redhead married to fiery Cuban bandleader.
Is this an actual question from a NCLEX review book? There is not nearly enough info to me there. Pain is a vital sign as is the heart rate. The question just says they are going through withdrawal, not what is accompanying the withdrawal as we don't know what is accompanying the sickle cell crisis.
But if someone was admitted for sickle cell crisis and the fact that pain is indicative that the crisis is getting worse, I would go and do an assessment, looking at their O2 sat rate and respiratory rate. 107 is not alarming on the heart rate. It is going to be elevated because they are withdrawing. I'm trying to understand where the circulation problem is being read into this.
I have always been taught you cannot read information that is not there. I was also taught that you assess every hour on a COWS form with someone who is withdrawing. The fact the sickle cell patient is complaining of pain tells me something is happening in the crisis, provided their routine pain medication has not warn off. Sickle cell is painful. If they were admitted, they were on some kind of pain medication. This is why I saying there is not near info info. Also, a nurse would be given more info in report.
divobari
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