Kaplan question about sickle cell anemia

[DisneyNurse18]

Ok in school the instructors always said the first thing you should do for a sickle patient in crisis is provide oxygen. In Kaplan they are saying give the patients iv fluids.......who's right???

[*ac*]

I don't know the right answer but in reality, the first thing I try to do is get them their pain meds.

Hopefully only one of these answers will be on an NCLEX question.

[LaceyRN]

Oh, I know! I am so frustrated with Kaplan and I just got it. We were taught in my program that pain control is a priority and Kaplan says it's a psychosocial need and to eliminate it as an answer on the NCLEX...SAY WHAT??!!

I am so confused now on how to establish priorities for NCLEX that I want to cry. I know pain control would have been the correct answer on an exam at my school. No other answer dealth with ABC's either or I would have understood the rationale. I think I am regretting buying this book.

I seem to do well on Saunders, Lippencott, and Straight A's series but not this one.

[sweet_soul79]

Pain is psycosocial need, so you eliminate it. rest of the choices, i would apply ABCs.

for your particular question about sickle cell crisis, it depends if patient is hemorraging, then 1st priority would be providing IV fluids, and then oxygen. But it all depends on how the question is worded.

Hope, it make sense.

[ChristineN, BSN, RN]

Ok in school the instructors always said the first thing you should do for a sickle patient in crisis is provide oxygen. In Kaplan they are saying give the patients iv fluids.......who's right???

I'm taking Kaplan and we just went over Sickle Cell in class. The way it was explained was that with sickle cell, your priorities are oxygenation and pain control. So, if you only have one of those to choose from, that would be the answer. If you have both, obviously oxygenation takes priority.

[TangoLima]

In Sickle Cell, the cells are not sickled all the time, but sickle in response to some sort of stress. One of the major stressors leading to sickling is dehydration. When the cells are dehydrated, they sickle, and then are not capable of becoming oxygenated. So, you can give a patient O2 all day, but if their cells cannot hold the oxygen, it will not matter. Your first priority is rehydrating the patient and having the cells resume their normal shape. In reality, you would do all the things mentioned....pain, O2, and hydration. But, in NCLEX, you can only choose one answer.

I understand your frustration. I have come to realize that taking the NCLEX is not so much about what you know, but rather learning HOW to take the test, and knowing what NCLEX wants to hear. I hate that, but it is the nature of the beast.

Hope that helps.

[2008China]

A lot of kaplan questions are confused!not just sickle cell anemia,sometimes I want to cry too !

[DisneyNurse18]

Tango that makes sense THANK YOU!!!!!! :yeah::yeah: