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1.5 CE Test Hours

Understanding the Complications of Sickle Cell Disease

Contrada, Emily

AJN The American Journal of Nursing: June 2019 - Volume 119 - Issue 6 - p 36
doi: 10.1097/01.NAJ.0000559780.78687.0e
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TEST INSTRUCTIONS

  • Read the article. Take the test for this CE activity online at www.nursingcenter.com/ce/ajn.
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  • For questions, contact LPD: 1-800-787-8985.
  • Registration deadline is June 4, 2021.
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PROVIDER ACCREDITATION

  • LPD will award 1.5 contact hours for this continuing nursing education (CNE) activity. LPD is accredited as a provider of CNE by the American Nurses Credentialing Center's Commission on Accreditation.
  • This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hours. LPD is also an approved provider of CNE by the District of Columbia, Georgia, and Florida #50-1223. Your certificate is valid in all states.
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PAYMENT

  • The registration fee for this test is $17.95.
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Understanding the Complications of Sickle Cell Disease

GENERAL PURPOSE:

To discuss the genetic, hematologic, and clinical features of sickle cell disease (SCD) and its major health complications, as well as review the nursing implications of each complication.

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LEARNING OBJECTIVES/OUTCOMES:

After completing this continuing education activity, you should be able to

  • summarize the defining characteristics of and the precipitating and risk factors for SCD and its complications.
  • list the clinical manifestations of SCD and its complications.
  • plan appropriate interventions for patients with SCD.
  1. Sickled cells can become trapped in small blood vessels, causing pain, oxygen deprivation, and organ damage, primarily because these cells are
    1. tiny.
    2. rigid.
    3. edematous.
  2. Of the following primary sickle cell disease (SCD) genotypes, which is usually the most clinically severe?
    1. HbSβ+-thalassemia
    2. HbSC
    3. HbSβ0-thalassemia
  3. Identifying SCD in newborns enables physicians to initiate which of the following prophylactic measures?
    1. a course of antiviral therapy
    2. early Streptococcus pneumoniae immunization
    3. hydroxyurea administration for the first 6 months
  4. Among men and women with SCA, the median age at death is
    1. 42 and 48 years, respectively.
    2. 54 and 58 years, respectively.
    3. 60 and 68 years, respectively.
  5. The first SCD-related complication experienced by infants and toddlers is often
    1. respiratory distress.
    2. dactylitis.
    3. sepsis.
  6. The majority of painful episodes experienced by patients with SCD
    1. follow extreme temperature exposure.
    2. are triggered by alcohol ingestion.
    3. have no identifiable cause.
  7. Which of the following is contraindicated for pain relief during a vasoocclusive episode (VOE)?
    1. ice application
    2. heat application
    3. acupuncture
  8. When patients with SCD are having a VOE, nurses should encourage them to
    1. restrict fluids.
    2. remain on bed rest.
    3. walk and use the incentive spirometer every hour.
  9. In a prospective cohort study by Smith and colleagues, 29% of patients with SCD experienced pain
    1. almost daily.
    2. on 42% or fewer days.
    3. on 5% or fewer days.
  10. The VOEs of SCD are especially common in
    1. ligaments.
    2. muscle tissue.
    3. bone marrow.
  11. A common precipitating factor for priapism is
    1. fever.
    2. urination.
    3. alcohol ingestion.
  12. To help patients with SCD prevent episodes of priapism, nurses should recommend
    1. sleep.
    2. exercise.
    3. antihistamines.
  13. A common manifestation of acute chest syndrome (ACS) in adults with SCD is
    1. pleuritic chest pain.
    2. dry cough.
    3. wheezing.
  14. Although IV fluid administration is often a component of treating VOEs, excessive fluids can precipitate ACS by causing
    1. hypertension.
    2. pulmonary edema.
    3. an increase in hematocrit.
  15. Risk factors for ischemic stroke in patients with SCD include having
    1. the HbSC genotype.
    2. a history of pneumonia.
    3. a low hemoglobin level.
  16. Manifestations of hemorrhagic stroke include
    1. severe headache.
    2. bounding pulse.
    3. sudden fatigue.
  17. Manifestations of acute splenic sequestration crisis include
    1. bradycardia.
    2. chest pain.
    3. pallor.
  18. A common precipitant of VOE and the most common cause of ACS is
    1. stress.
    2. infection.
    3. dehydration.
  19. The first manifestation of chronic kidney disease in patients with SCD is
    1. microalbuminuria.
    2. decreased calcium.
    3. increased creatinine.
  20. Risk factors for both acute renal failure and chronic kidney disease include
    1. female sex.
    2. hypothyroidism.
    3. past blood transfusion.
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