Hesi quizlet med surg

2. disturbed sleep pattern. 3. risk for infection. 4. Chronic Pain. 1. urinary retention. Study with Quizlet and memorize flashcards containing terms like A client is admitted with rapid atrial flutter is receiving amiodarone 1mg/min via a peripheral line. The UAP reports to the nurse that the client's HR is 90 BPM, and BP is 110/50.

ABDEF The total assessment of the respiratory system includes pulse oximetry; auscultation; skin and nail-bed assessment for the detection of cyanosis; and rate, character, and degree of effort of respirations. The apical radial pulse is a cardiac assessment. NCLEX Learn with flashcards, games, and more — for free.Study with Quizlet and memorize flashcards containing terms like While assessing the health of a female client, the nurse suspects endocrine dysfunction. Which findings support the nurse's suspicion? Select all that apply. 1. Diminished pubic hair 2. Yellow-colored urine 3. Pulse of 74 bpm 4. Protrusion of eyeballs 5. Blood pressure of 172/80 mmHg, The …Study with Quizlet and memorize flashcards containing terms like What instruction should the nurse include in the discharge teaching plan of a client who had a cataract extraction today?, A male adult comes to the urgent care clinic 5 days after being diagnose with influenza. He is short of breath, febrile, and coughing green colored sputum. Which intervention should the nurse implement first ...Med Surg Exam 2023 (2) - HESI Questions. HESI Questions. Course. Medical-Surgical Nursing (NUR1211) 720 Documents. Students shared 720 documents in this course. University ... Med Surg Chapter 23 - Practice questions and answers for the exam. Anemia ATI Active Learning Template System Disorder Covid;HESI - Med-Surg. The nurse knows that lab values sometimes vary for the older client. Which data would the nurse expect to find when reviewing laboratory values of an 80-year-old male? A - Increased WBC, decreased RBC. B - Increased serum bilirubin, slightly increased liver enzymes. C - Increased protein in the urine, slightly increased serum ... provide oxygen. A client status post-48 hours femoral rod placement surgery, suddenly complains of chest pain and becomes short of breath, pale, and diaphoretic. The practical nurse (PN) immediately assesses their vital signs and obtains 100/80 mm Hg blood pressure, 110 beats/min heart rate, and 36 breaths/min respiratory rate.

1.Anxiety 2.Leukocytosis 3.Chvostek's sign 4.Urinary output of 800 mL/hour 5.Clear drainage on nasal dripper pad. 2, 4, 5. The nurse is evaluating a client's use of a cane for left-sided weakness. The nurse should intervene and correct the client if the nurse observed that the client performs which action? 1.Study with Quizlet and memorize flashcards containing terms like 1 2022 HESI Med Surg Exit Exam (V1 Version 1) Brand New Q&As + Guaranteed A+ TEST 1 Multiple Choice Identify the letter of the choice that best completes the statement or answers the question. 1. While assessing a client with diabetes mellitus, the nurse observes an absence of hair …Hypertension. -Equal to or greater than 140/90 mmHg. -Cause: steroids or estrogen. -Meds can cause hypokalemia. Postural Hypotension. Difference of more than 10 mm Hg of either systolic or diastolic. Hypokalemia Symptoms. Dry mouth, thirst, weakness, drowsiness, lethargy, muscle aches, tachycardia. Raynaud Disease. Study with Quizlet and memorize flashcards containing terms like A 20-year-old female client calls the nurse to report a lump she found in her breast. Which response is the best for the nurse to provide? A) Check it again in one month, and if it is still there schedule an appointment. B) Most lumps are benign, but it is always best to come in for an examination. C) Try not to worry too much ... Study with Quizlet and memorize flashcards containing terms like A female client receiving IV vasopressin for esophageal varice rupture reports to the nurse that she feels substernal tightness and pressure across her chest. Which PRN protocol should the nurse initiate? A) Start and IV nitroglycerin infusion. B) Nasogastric lavage with cool saline. C) Increase the vasopressin infusion. Prepare ...The nurse should assess this client for a pulse deficit because this condition occurs with atrial fibrillation. A client with type II diabetes arrives at the clinic with a blood glucose of 50 mg/dL. The nurse provides the client with 6 ounces of orange juice. In 15 minutes the client's capillary glucose is 74 mg/dL.a. cover the burned area with sterile gauze. b. inspect mouth for signs of inhalation. c. administer intravenous pain medication. d. draw blood for a CBC. b. inspect mouth for signs of inhalation. Study with Quizlet and memorize flashcards containing terms like 1. A nurse in a burn treatment center is caring for a client who is admitted with ...20 g of protein, 2000 calories. A nurse concludes that the anemia that accompanies chronic kidney disease should be treated because it contributes to: Chronic fatigue. A client is scheduled to receive general anesthesia during an upcoming surgery. The nurse provides education about common side effects of general anesthesia.

The client should be placed on contact precautions. A client with a history of hypertension, myocardial infarction, and heart failure is admitted to the surgical intensive care unit after coronary artery bypass surgery graft (CABG). The nurse determines the client's serum potassium level is 4.5 mEq/L.Rationale. A decrease in hematocrit and hemoglobin would typically occur within 4 to 6 hours of the start of a UGI bleed. The client's platelet count would rise in response to the bleed as the body attempts to stop the bleeding. Oxygen saturation levels would decrease when the client has lost a large quantity of blood.Get free real-time information on USD/MED quotes including USD/MED live chart. During times of turbulence and uncertainty in the markets, many investors turn to dividend-yielding s...Study with Quizlet and memorize flashcards containing terms like 1 2022 HESI Med Surg Exit Exam (V1 Version 1) Brand New Q&As + Guaranteed A+ TEST 1 Multiple Choice Identify the letter of the choice that best completes the statement or answers the question. 1. While assessing a client with diabetes mellitus, the nurse observes an absence of hair …Priority: manage hypoxia, acidosis and hypothermia > airway, oxygen Management: CPR, core temp (rectal) rewarming procedures during CPR, trach/PEEP, O2 Risks: ARDS> hypoxia, hypercarbia and respiratory acidosis can occur Hypothermia> metabolic acidosis NGT> decompress stomach and prevent aspirating gastric contents. Monitor: ECG, ICP, …

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Study with Quizlet and memorize flashcards containing terms like The nurse observes ventricular fibrillation on telemetry and, on entering the client's bathroom, finds the client unconscious on the floor. Which intervention should the nurse implement first? A. Administer an antidysrhythmic medication. B. Start cardiopulmonary resuscitation. C. Defibrillate the client at 200 J. D. Assess the ...Nov 15, 2022 ... evolve med surg hesi quiz. Teacher50 terms. Profile Picture · mrpsychnp. Preview. Med Surg II Chapter 35. 30 terms. Profile Picture · dpaterra1.a. Place their body weight on the crutches. b. Advance the unaffected leg onto the stair. c. Shift their weight from the crutches to the unaffected leg. d. Then bring the crutches and the affected leg up to the stairs. Study with Quizlet and memorize flashcards containing terms like A home health nurse is assigned to a client who was recently ...a. decreased renal blood flow. b. increased gastrointestinal motility. c. decreased ratio of adipose tissue to lean body mass. d. increased total body water. D. Because 1 L of water weighs 1 kg, change in body weight is a good measure of excess fluid loss or fluid retention.

Med Surge 3 hesi final. Flail chest is frequently a complication of blunt chest trauma, which may occur from a steering wheel injury, motor vehicle crash involving a pedestrian or cyclist, a significant fall onto the chest, or an assault with a blunt weapon. As with rib fracture, treatment of flail chest is usually supportive. A: Raise the head of the client's bed to 45° and flex the client's knees. B: Switch out their gloved hand for the UAP's non -gloved hand. C: Instruct the UAP to gently take their hand off the client's dressing. D: Maintain direct pressure on dressing and transport client to the operating room. med surg hesi v1 Flashcards | Quizlet. 4.6 (25 reviews) The nurse obtains a fingerstick glucose level utilizing bedside lancet/glucose meter equipment from a client with prescribed sliding scale insulin protocol. The meter indicates 56 mg/dl (3.12 mmol/l). At this time which intervention should the nurse implement first?Study with Quizlet and memorize flashcards containing terms like A client with a productive cough has obtained a sputum specimen for culture as instructed. What is the best initial nursing action?, A client is brought to the ED by ambulance in cardiac arrest with cardiopulmonary resuscitation (CPR) in progress.The client is intubated and is receiving 100% oxygen per self-inflating (ambu) bag ... Study with Quizlet and memorize flashcards containing terms like Based on the clinical manifestations of Cushing syndrome, which nursing intervention would be appropriate for a client who is newly diagnosed with Cushing syndrome? A. Monitor blood glucose levels daily. B. Increase intake of fluids high in potassium. C. Encourage adequate rest between activities. D. Offer the client a sodium ... HESI: med surg. Get a hint. Burns. Click the card to flip 👆. Tissue injury or necrosis caused by transfer of energy from a heat source to the body. Click the card to flip 👆. 1 / 222.A: Raise the head of the client's bed to 45° and flex the client's knees. B: Switch out their gloved hand for the UAP's non -gloved hand. C: Instruct the UAP to gently take their hand off the client's dressing. D: Maintain direct pressure on dressing and transport client to the operating room. Hesi Review - Med Surg. A client who has undergone abdominal surgery calls the nurse and reports that she just felt "something give way" in the abdominal incision. The nurse checks the incision and notes the presence of wound dehiscence. The nurse immediately: Click the card to flip 👆. Covers the abdominal wound with a sterile dressing ... Here is how to score over 850 in your Hesi, ATI Exams for Hesi Medical Surgical Exam! In this video I mention heavily tested topics and topics you must revie...1 Trimming toenails so that they are short and rounded. 2 Checking bathwater temperature by putting the toes in first. 3 Using alcohol to rub hands, feet, legs, and arms at least two times a day. 4 Seeking professional treatment for any minor injuries to the extremities.

A. Frequent use of chewable and liquid antacids for indigestion. B. Severe abdominal cramps and diarrhea after eating spicy foods. C. Upper mid-abdominal pain described as gnawing and burning. D. Marked loss of weight and appetite over the last 3 or 4 months. C. Upper mid-abdominal pain described as gnawing and burning.

HESI: Med-Surg: Gastrointestinal System. Hiatal Hernia. Click the card to flip 👆. -Herniation of the esophagogastric junction and a portion of the stomach into the chest through the esophageal hiatus of the diaphragm. -Don't eat: caffeine, catsup, strawberries, and chocolate. -Stop eating 3 hours before bedtime & sit up for 1 hours after eating.Med Surg 2 HESI. What does it mean when there is no fluctuation in the water seal chamber of a chest tube? The tubing may be kinked or there may be an occlusion. Start studying Med Surg 2 HESI. Learn vocabulary, terms, and more with flashcards, games, and other study tools.Study with Quizlet and memorize flashcards containing terms like The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates the client may have developed septic emboli? A. Cyanosis of the fingertips. B. Bradycardia and bradypnea. C. Presence of S3 and S4 heart sounds. D. 3+ pitting edema of the lower extremities., A 77 …The best way to study. Sign up for free. By signing up, you accept Quizlet's Terms of Service and ...Abstinence of smoking or use of tobacco. Moderate- Vigorous aerobic exercise 2Xs a week for 30 minutes. Healthy eating habits of mostly whole grains, fruits and ...MED SURG 1 HESI Flashcards | Quizlet.pdf - MED SURG 1 HESI... Doc Preview. Pages 7. Identified Q&As 16. Solutions available. Total views 100+. Miami Dade College, Miami. …Hypertension. -Equal to or greater than 140/90 mmHg. -Cause: steroids or estrogen. -Meds can cause hypokalemia. Postural Hypotension. Difference of more than 10 mm Hg of either systolic or diastolic. Hypokalemia Symptoms. Dry mouth, thirst, weakness, drowsiness, lethargy, muscle aches, tachycardia. Raynaud Disease.The best way to study. Sign up for free. By signing up, you accept Quizlet's Terms of Service and ...

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MED SURG 2024 HESI PRACTICE QUESTIONS AND ANSWERS. The nurse is assessing a 48-year-old client with a history of smoking during a routine clinic visit. The client, who exercises regularly, reports having pain in the calf during exercise that disappears at rest. Which of the following findings requires further evaluation? Heart rate 57 bpm.Study with Quizlet and memorize flashcards containing terms like The nurse assesses a postoperative client whose skin is cool, pale, and moist. The client is very restless and has scant urine output. ... HESI MED SURG #1 TEST. 42 terms. virgobutterflies. Preview. lec 3 - ankle + foot disorders PART TWO. 124 terms. katybrookee. Preview. Chapter ...A. Blood supply to the heart is diminished by artherosclerotic lesions, which necessitate lifestyle changes. B. Blood vessels supplying the pumping chamber have blockages indicating a past heart attack. C. Three main arteries have major blockages, with only 1 to 5% of blood flow getting through to the heart muscle. Hyperosmolar hyperglycemic syndrome (HHS) cause: blood glucose is too high for too long leading to severe dehydration, thirst, fever, dry mouth, and confusion. treatment: fluids (NS), IV insulin, and electrolyte replacement. less common than DKA but more dangerous, occurs in type 2. Select the 5 assessment findings that are consistent with acute rheumatic fever. murmur. opening snap. joint pain. painless nodules over elbows. previous sore throat and upper respiratory infection. After initiating antibiotic therapy on a client with syphilis, the nurse suspects a Jarisch-Herxheimer reaction (JHR).Study with Quizlet and memorize flashcards containing terms like The nurse is providing postprocedure care to a client who had a cardiac catheterization. The client begins to manifest signs and symptoms associated with embolization. Which action should the nurse take? Notify the primary healthcare provider immediately Apply a warm, moist compress …Study with Quizlet and memorize flashcards containing terms like An adult client who is hospitalized after surgery reports sudden onset of chest pain and dyspnea. The client appears anxious, restless, and mildly cyanotic. The nurse should further assess the client for which condition? A. Pulmonary embolism. B. Heart failure. C. Tuberculosis. D. …Med Surg Exam 2023 (2) - HESI Questions. HESI Questions. Course. Medical-Surgical Nursing (NUR1211) 720 Documents. Students shared 720 documents in this course. …Med Surg Exam 2023 (2) - HESI Questions. HESI Questions. Course. Medical-Surgical Nursing (NUR1211) 720 Documents. Students shared 720 documents in this course. University ... Med Surg Chapter 23 - Practice questions and answers for the exam. Anemia ATI Active Learning Template System Disorder Covid; ….

Study with Quizlet and memorize flashcards containing terms like The nurse is completing a health assessment of a 42-year-old female with suspected Graves' Disease. The nurse should assess this client for: 1. anorexia 2. tachycardia 3. weight gain 4. cold skin, When conducting a health history with a female client with thyrotoxicosis, the nurse should ask …Study with Quizlet and memorize flashcards containing terms like The nurse is providing postprocedure care to a client who had a cardiac catheterization. The client begins to manifest signs and symptoms associated with embolization. Which action should the nurse take? Notify the primary healthcare provider immediately Apply a warm, moist compress … Study with Quizlet and memorize flashcards containing terms like A female client with a nasogastric tube attached to low suction states that she is nauseated. The nurse assesses that there has been no drainage through the nasogastric tube in the last 2 hours. Which action should the nurse take first? A. Irrigate the nasogastric tube with sterile normal saline. B. Reposition the client on her ... Study Guide for HESI RN Med Surg Exam: Test Bank, Notes, and | Course Hero. Updated 2023 HESI MED SURG V2 TEST BANK STUDY GUIDE NOTES RN.docx. Doc Preview. Pages 46. Identified Q&As 45. Solutions available. Total views 100+. Northwest Missouri State University. NURS MISC. MagistrateHornetMaster680. 4/23/2023. 76% (45) View …HESI: MED SURG Respiratory. Get a hint. HESI HINT: FEVER. Click the card to flip 👆. CAN CAUSE DEHYDRATION BECAUSE OF EXCESSIVE FLUID LOSS DUE TO DIAPHORESIS. INCREASED TEMPERATURE ALSO INCREASES METABOLISM AND THE DEMAND FOR 02. Click the card to flip 👆. 1 / 27.See an expert-written answer! We have an expert-written solution to this problem!If you are in the healthcare industry, here is an insight into the role of a med tech job description so you can hire the right person. A Med Tech, or Medical Technologist, plays a...BotoPlace specializes in just one med spa service, Botox, and by focusing on this niche it has allowed the company to thrive. There are tons of Med Spas around the U.S. Most offer ... Dehydration. *no water, no salt, or both*. Inadequate fluid intake. vomiting & diarrhea. Low-sodium diet or no sodium intake. Can be caused by sodium or water loss. watch for changes in skin turgor, hypovolemia, tachycardia, weak pulse, confusion, thirst, dry skin, skicky or dry mucous membranes, weight loss, urine concentrated. Study with Quizlet and memorize flashcards containing terms like The nurse is completing a health assessment of a 42-year-old female with suspected Graves' disease. The nurse should assess this client for: A. Anorexia B. Tachycardia C. Weight Gain D. Cold Skin, A 34-year-old female is diagnosed with hypothyroidism. ... Med Surg HESI Practice. Teacher … Hesi quizlet med surg, Study with Quizlet and memorize flashcards containing terms like Thiazides diuretics, Thiazide diuretics (Indications), Thiazides diuretics ( Adverse ..., Med Surg 2 HESI. What does it mean when there is no fluctuation in the water seal chamber of a chest tube? The tubing may be kinked or there may be an occlusion. Start studying Med Surg 2 HESI. Learn vocabulary, terms, and more with flashcards, games, and other study tools., c. The client reports feeling as tired as at the last visit by the nurse. d. Upon entering the home, the PN noticed dirty dishes and clothing scattered around the home. b. A weight loss of 5 pounds since the last monthly home visit. A weight loss of 5 pounds in 1 month is a concern., The client should be placed on contact precautions. A client with a history of hypertension, myocardial infarction, and heart failure is admitted to the surgical intensive care unit after coronary artery bypass surgery graft (CABG). The nurse determines the client's serum potassium level is 4.5 mEq/L., Study with Quizlet and memorize flashcards containing terms like Chest Trauma- Complications, Shock Fluid, Hypovolemic Shock and more. ... ( Red HESI Test bank Med-Surg and other resources) Teacher 302 terms. mrpsychnp. Preview. HESI 799 RN Exit Exam. 798 terms. houston-lover. Preview. Wounds and Fractures. 55 terms. katiemonique., Study with Quizlet and memorize flashcards containing terms like Thiazides diuretics, Thiazide diuretics (Indications), Thiazides diuretics ( Adverse ..., Quizlet has study tools to help you learn anything. Improve your grades and reach your goals with flashcards, practice tests and expert-written solutions today., 1. A primigravid client at 26 weeks' gestation asks the nurse what causes heartburn. during pregnancy. The nurse should explain to the client that heartburn during pregnancy. is usually caused by which of the following? 1. Increased peristaltic action during pregnancy. 2. Displacement of the stomach by the diaphragm., Sun, sea and stagnation. This is the story of Club Méditerranée, the resort operator better known as Club Med, in recent years. Sun, sea and stagnation. This is the story of Club M..., Study with Quizlet and memorize flashcards containing terms like An older client is seen in the clinic for an annual physical exam. Which finding should the practical nurse report to the healthcare provider for follow-up? A) Hemoglobin 9.1 grams/dl with positive occult blood in stool. B) Serum carcinoembryonic antigen (CEA) level is low. C) Bowel sounds auscultated with occasional borborygmi ..., A pt with a history of type 1 diabetes mellitus and astma is readmitted to the unit for the 3rd time in 2 months with a current fasting blood sugar of 325 mg/dl ..., Study with Quizlet and memorize flashcards containing terms like A 20-year-old female client calls the nurse to report a lump she found in her breast. Which response is the best for the nurse to provide? A) Check it again in one month, and if it is still there schedule an appointment. B) Most lumps are benign, but it is always best to come in for an examination. C) Try not to worry too much ..., provide oxygen. A client status post-48 hours femoral rod placement surgery, suddenly complains of chest pain and becomes short of breath, pale, and diaphoretic. The practical nurse (PN) immediately assesses their vital signs and obtains 100/80 mm Hg blood pressure, 110 beats/min heart rate, and 36 breaths/min respiratory rate. , Study with Quizlet and memorize flashcards containing terms like List four categories of burns., Burn depth is a measure of severity. Describe the characteristics of superficial partial-thickness, deep partial-thickness, and full-thickness burns., Describe fluid management in the emergent phase, acute phase, and rehabilitation phase of the burned client. and more., A. Encourage fluids to 3000 mL per day. B. Change the client's position every two hours. C. Keep the head of the bed elevated 30 degrees. D. Turn off the television and darken the room. D. Turn off the television and darken the room. Study with Quizlet and memorize flashcards containing terms like Three weeks after discharge for an acute ..., Study with Quizlet and memorize flashcards containing terms like A patient had abdominal surgery and states that after coughing it feels like his guts has spilled out. What should the nurse do first?, A patient has been taking Kenalog (corticosteroid) with increase redness..., A patient hd a BDP. ... HESI Med Surg 2018 v1v2v3. 156 terms. clairethefox3. Preview. …, Study with Quizlet and memorize flashcards containing terms like Which description of symptoms is characteristic of a client diagnosed with trigeminal neuralgia (tic douloureux)? Tinnitus, vertigo, and hearing difficulties Sudden, stabbing, severe pain over the lip and chin. Facial weakness and paralysis. Difficulty in chewing, talking, and swallowing., A client with a 16-year history of ..., 15 minutes. A client with HTN who has been taking labetalol ..., Study with Quizlet and memorize flashcards containing terms like The nurse observes ventricular fibrillation on telemetry and, on entering the client's bathroom, finds the client unconscious on the floor. Which intervention should the nurse implement first? A. Administer an antidysrhythmic medication. B. Start cardiopulmonary resuscitation. C. Defibrillate the client at 200 J. D. Assess the ..., 13 of 302. Quiz yourself with questions and answers for Med Surg Test bank ( Red HESI Test bank Med-Surg and other resources), so you can be ready for test day. Explore quizzes and practice tests created by teachers and students or create one from your course material., Location of gastric ulcers. Lesser curvature of the stomach. Location of duodenal ulcers. Occur in the duodenum. Most common location of peptic ulcer disease. Study with Quizlet and memorize flashcards containing terms like Burns, Categories of Burns, Tissue destruction results from and more., Study with Quizlet and memorize flashcards containing terms like A patient had abdominal surgery and states that after coughing it feels like his guts has spilled out. What should the nurse do first?, A patient has been taking Kenalog (corticosteroid) with increase redness..., A patient hd a BDP. ... HESI Med Surg 2018 v1v2v3. 156 terms. clairethefox3. Preview. …, Looking for the best study guides, study notes and summaries about med surg hesi 2023-2024 complete? On this page you'll find 84 study documents about med ..., , A fair-skinned female client who is an avid runner is diagnosed with malignant melanoma, which is located on the lateral surface of the lower leg. After wide ..., Study with Quizlet and memorize flashcards containing terms like A client with a productive cough has obtained a sputum specimen for culture as instructed. What is the best initial nursing action?, A client is brought to the ED by ambulance in cardiac arrest with cardiopulmonary resuscitation (CPR) in progress.The client is intubated and is receiving 100% oxygen per self-inflating (ambu) bag ..., Study with Quizlet and memorize flashcards containing terms like The nurse is providing postprocedure care to a client who had a cardiac catheterization. The client begins to manifest signs and symptoms associated with embolization. Which action should the nurse take? Notify the primary healthcare provider immediately Apply a warm, moist compress …, Study with Quizlet and memorize flashcards containing terms like What instruction should the nurse include in the discharge teaching plan of a client who had a cataract extraction today?, A male adult comes to the urgent care clinic 5 days after being diagnose with influenza. He is short of breath, febrile, and coughing green colored sputum. Which intervention should the nurse implement first ... , Study with Quizlet and memorize flashcards containing terms like Midazolam, Lorcaserin, Orlistat and more., Study with Quizlet and memorize flashcards containing terms like STROKE pt slurred speech and frightened. which clinical manifestations should the RN expect to find if symptoms are caused by a stroke - bruit where - BP is - DTR are - vision is aka, why do hyporeflexic deep reflexes occur in a stroke, pt w/ suspected stroke being reasessed q …, A.) If you feel tired and short of breath, lie down flat and prop up your feet. B.) Eating liver several times a week will help build up your strength. C.) Your daily dose of furosemide should be taken first thing in the morning. D.) The dose of enalapril will help prevent vasodilation from occurring. Answer: C. 1., an autosomal recessive disorder in which an abnormal Hgb S "sickles" and obstructs the blood vessels due to dehydration, hypoxemia, & acidosis. s/s of sickle cell anemia. -acute pain of back, chest, & long bones. -fever. -painful swollen joints., See an expert-written answer! We have an expert-written solution to this problem!