A 14-year-old male child with sickle cell anemia is being discharged after treatment for a crisis. Which instructions for avoiding future crises should the nurse provide the child and family? Select the 3 that apply.

Drink plenty of fluids

Restrict any physical activities

Report a fever to an adult immediately

Wash hands before meals and after playing

Use cold pack to relieve joint pain

Answer and Explanation

Correct Answer : A,C,D

Rationale:

A. Drink plenty of fluids: Adequate hydration helps prevent sickling of red blood cells by reducing blood viscosity, which lowers the risk of vaso-occlusive crises. Encouraging fluid intake is essential in crisis prevention and maintaining overall health.

B. Restrict any physical activities: Completely restricting physical activity is not necessary and can negatively impact the child’s physical and emotional well-being. Moderate, supervised activity is usually encouraged, with avoidance of extreme exertion or dehydration.

C. Report a fever to an adult immediately: Fever can signal infection, which is a common trigger for sickle cell crises. Early reporting ensures prompt medical evaluation and treatment to prevent complications.

D. Wash hands before meals and after playing: Proper hand hygiene reduces the risk of infections, which can precipitate sickle cell crises. Teaching good hygiene practices is critical for infection prevention.

E. Use cold pack to relieve joint pain: Cold can cause vasoconstriction and worsen sickling; therefore, warm compresses are preferred to relieve joint pain. Using cold packs is contraindicated in managing sickle cell pain crises.

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Free Nursing Study Resources

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

Rationale for Correct Choices:

• Cracked lips and strawberry tongue are hallmark mucocutaneous changes in Kawasaki disease, reflecting widespread inflammation of mucous membranes in the acute phase. These are often accompanied by conjunctival injection and rash.

• Aspirin and IV gamma globulin are the mainstay treatments for Kawasaki disease, reducing inflammation and significantly lowering the risk of coronary artery aneurysms when given early in the illness.

Rationale for Incorrect Choices:

• Petechiae and purpura rash are more commonly seen in platelet or clotting disorders such as idiopathic thrombocytopenic purpura or meningococcemia. Kawasaki disease typically presents with diffuse erythematous rash, not pinpoint hemorrhages.

• Polyarthritis may occur in the later stages of Kawasaki disease, but chorea is a neurological manifestation linked to rheumatic fever. This combination does not fit the acute presentation of Kawasaki disease.

• Corticosteroids and antibiotics are not first-line treatments for Kawasaki disease. Antibiotics are ineffective as the cause is not bacterial, and corticosteroids are generally reserved for IVIG-resistant cases.

• ACE inhibitors and NSAIDs are not standard therapy for Kawasaki disease. ACE inhibitors are used in hypertension or heart failure, and NSAIDs are not as effective as high-dose aspirin in reducing the acute inflammatory response in this condition.

Correct Answer is ["12.5"]

Explanation

Calculation:

Desired dose = 400 mg.

Available concentration = 325 mg per 10.15 mL.

Calculate the volume to administer in milliliters (mL).

Volume (mL) = Desired dose (mg) / (Available amount (mg) / Available volume (mL))

= 400 mg / (325 mg / 10.15 mL)

= 400 mg / 32.02 mg/mL

= 12.492 mL.

Round to the nearest tenth

= 12.5 mL.

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A 14-year-old male child with sickle cell anemia is being discharged after treatment for a crisis. Which instructions for avoiding future crises should the nurse provide the child and family? Select the 3 that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse on the pediatric floor is taking care of a patient just diagnosed with Kawasaki Disease. On exam, the nurse can expect to find this hallmark clinical finding dropdown: and to administer these medications: dropdown.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

The child is prescribed Acetaminophen 400mg PO q4h for 24 hours for fever. They weigh 60 pounds. Safe dose range: Acetaminophen 10-15 mg/kg/dase PO q4-6h. Available Concentration: 325 mg per 10.15 mLs How many mLs will the nurse administer q4 hours? Round your answer to the nearest tenth

Correct Answer is ["12.5"]

Explanation

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