A 10-year-old child is admitted to the emergency department with a sickle cell crisis.
Which of the following interventions should the nurse prioritize to manage the crisis effectively?
Withholding pain medication to prevent addiction.
Encouraging the child to perform physical exercises.
Administering intravenous fluids for hydration.
Applying cold compresses to painful areas.
The Correct Answer is C
Managing a sickle cell crisis necessitates understanding the pathophysiology of vaso-occlusive events. Priority is placed on reversing sickling by improving perfusion and oxygenation. Knowledge of fluid resuscitation and pain management protocols is critical to prevent permanent tissue damage and complications.
Choice A rationale
Adequate pain management is essential during a crisis because the pain is severe due to tissue ischemia. Withholding analgesics is unethical and physiologically harmful, as uncontrolled pain can increase metabolic demands and worsen the overall clinical condition.
Choice B rationale
Physical exertion increases oxygen consumption and can worsen the sickling of red blood cells. During an acute crisis, the client should remain on bed rest to minimize metabolic demands and prevent further vaso-occlusive events in the peripheral vasculature.
Choice C rationale
Hydration reduces blood viscosity, which is vital for preventing the sickling of red blood cells (normal RBC lifespan is 120 days). IV fluids help dilute the concentration of sickle cells, improving blood flow through obstructed vessels and tissues.
Choice D rationale
Cold temperatures cause vasoconstriction, which further impairs blood flow and promotes sickling. Warm compresses are preferred because they promote vasodilation and improve circulation to the affected areas, whereas cold applications would increase the risk of localized tissue infarction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Differentiating skull fracture types in pediatrics involves understanding bone structure and injury patterns. Knowledge of cranial anatomy, specifically the relationship between fracture lines and sutures, is necessary to identify the characteristics of linear fractures versus more complex cranial injuries.
Choice A rationale
Pushing bone fragments inward toward the brain parenchyma describes a depressed skull fracture. This type of injury carries a high risk of dural tears and direct brain tissue damage, requiring urgent neurological evaluation and intervention.
Choice B rationale
A linear fracture is a straight-line break in the cranial bone that follows the direction of the impact. These fractures typically do not cross the fibrous suture lines that separate the individual plates of the skull.
Choice C rationale
A break in the scalp or mucosa overlying a fracture defines a compound or open fracture. This condition creates a direct pathway for pathogens to enter the intracranial space, significantly increasing the risk of meningitis.
Choice D rationale
Multiple fracture lines that result in shattered bone fragments are characteristic of comminuted fractures. These injuries are often the result of high-energy impact and frequently involve complications that may necessitate surgical repair and stabilization..
Correct Answer is C
Explanation
Assessing pediatric respiratory distress requires recognizing compensatory mechanisms used to maintain oxygenation. Clinicians must identify physical signs indicating increased work of breathing and distinguish them from normal physiological findings to determine the severity of a child's clinical respiratory status.
Choice A rationale
Cyanosis is a late and critical sign of respiratory failure, indicating significant deoxygenation of hemoglobin. It signifies that compensatory mechanisms have failed, rather than serving as the most immediate indicator of the distress process itself.
Choice B rationale
Clear lung sounds generally indicate adequate air movement and an absence of fluid or obstruction. This finding would contradict a state of respiratory distress, which usually presents with adventitious sounds like wheezing, crackles, or stridor.
Choice C rationale
Intercostal retractions occur when the flexible chest wall is pulled inward during inspiration due to high negative intrapleural pressure. This physical sign is a primary indicator of increased effort needed to overcome airway resistance.
Choice D rationale
A normal respiratory rate, which is 20 to 30 breaths per minute for young children, indicates stability. Respiratory distress typically triggers tachypnea as the body attempts to increase minute ventilation to maintain adequate gas exchange.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.