A child weighing 36 kg is in moderate dehydration. Calculate the amount of ORS this child will need within 4 hours in mL. (Do not enter units)

Choice A reason:

Releasing traction every hour to perform skin care: Releasing traction every hour is not recommended as it can disrupt the alignment and healing process of the fractured femur. Skin care is important, but it should be performed without compromising the traction setup.

Choice B Reason:

Releasing traction once every 8 hours to check circulation: While checking circulation is crucial, releasing traction every 8 hours is not necessary and can interfere with the therapeutic benefits of traction. Circulation can be monitored without releasing the traction.

Choice C Reason:

Maintaining continuous traction until 1 hour before the scheduled surgery: Continuous traction is essential to maintain the alignment of the fractured femur. However, there is no need to release traction 1 hour before surgery unless specifically instructed by the surgical team.

Choice D Reason:

Maintaining continuous traction and checking the position of traction: This is the most appropriate action. Continuous traction ensures proper alignment and healing of the fractured femur. Regularly checking the position of traction helps prevent complications and ensures the effectiveness of the treatment.

Choice A reason:

Adequate oxygenation is important in managing vaso-occlusive sickle cell crisis, but the replacement of factor V is not relevant to this condition. Factor V is involved in the blood clotting process, and its replacement is typically associated with bleeding disorders such as hemophilia. Therefore, this choice is not appropriate for managing a vaso-occlusive crisis.

Choice B reason:

Adequate hydration and pain management are critical components of care for a child in vaso-occlusive sickle cell crisis. Hydration helps to reduce the viscosity of the blood, which can prevent further sickling of red blood cells and improve blood flow. Pain management is essential because vaso-occlusive crises are extremely painful and require prompt and effective pain relief, often with opioid analgesics. These measures help to alleviate symptoms and prevent complications.

Choice C reason:

Pain management is indeed a crucial aspect of care for vaso-occlusive sickle cell crisis, but the administration of heparin is not typically part of the treatment. Heparin is an anticoagulant used to prevent blood clots, and it is not indicated for managing vaso-occlusive crises. The focus should be on hydration and pain relief rather than anticoagulation.

Choice D reason:

Correction of acidosis may be necessary in some cases, but it is not the primary focus of care for vaso-occlusive sickle cell crisis. The main goals are to manage pain and ensure adequate hydration to improve blood flow and reduce the risk of further sickling of red blood cells. While addressing acidosis can be part of the overall management, it is not the primary intervention.