A nurse is assisting a child who has multiple closed fractures of the lower extremities due to a motor-vehicle crash.
The nurse should monitor the child for which of the following complications during the first 24 hr after the injury occurred?

Choice A rationale

Meperidine is not the first choice for pain management in sickle cell crisis due to its potential to cause seizures and other side effects.

Choice B rationale

Bed rest is recommended during a sickle cell crisis to decrease the body’s demand for oxygen, reduce the workload of the heart, and improve blood flow.

Choice C rationale

Limiting fluid intake is not recommended during a sickle cell crisis. Adequate hydration is important to prevent further sickling of cells and to maintain kidney function.

Choice D rationale

Cold compresses can cause vasoconstriction and may exacerbate the crisis. Warm compresses are usually recommended to increase blood flow and reduce pain.

The correct answer is choiceB.

Choice A rationale:

Dark brown blood in emesis is typically old blood and may not require immediate intervention.However, it should still be monitored and reported to the healthcare provider.

Choice B rationale:

Frequent swallowing can indicate active bleeding from the surgical site, which requires immediate intervention.This is a sign that the child may be swallowing blood, which can lead to significant blood loss.

Choice C rationale:

An axillary temperature of 38°C (100°F) is a mild fever and not uncommon postoperatively.It should be monitored, but it does not require immediate intervention.

Choice D rationale:

A pain level of 5 on the FACES scale indicates moderate pain, which is expected after a tonsillectomy.Pain management should be addressed, but it does not require immediate intervention.