A nurse is caring for a child who has sickle cell anemia.
Which of the following findings is the priority for the nurse to report to the provider?

The correct answer is Choice C.

Choice A rationale

Increasing fluid intake is not appropriate as it does not address the issue of vomiting and can lead to fluid overload.

Choice B rationale

Giving an antiemetic is not recommended without consulting a healthcare provider as it may interact with digoxin.

Choice C rationale

Administering the next dose as prescribed is the correct action. If a dose is vomited, it should not be repeated, and the next dose should be given at the regular time.

Choice D rationale

Mixing the medication with 8 oz of formula is not recommended as it can affect the absorption and effectiveness of the medication.

Choice A rationale:

A hoarse voice is consistent with the child’s condition. The child has a frequent cough and stridor, which can cause irritation and inflammation of the vocal cords, leading to a hoarse voice.

Choice B rationale:

Nasal flaring is a sign of respiratory distress. It indicates that the child is working harder to breathe, which is consistent with the observed symptoms of stridor, cough, and mild intercostal retractions.

Choice C rationale:

Increased appetite is not consistent with the child’s condition. The child is refusing to eat or drink and appears fatigued, which is typical in cases of respiratory distress and illness.

Choice D rationale:

Sitting upright and leaning forward is a common position adopted by children in respiratory distress. This position helps to open the airway and makes breathing easier.

Choice E rationale:

Decreased respiratory rate is not consistent with the child’s condition. The child’s respiratory rate has increased from 20/min to 24/min, indicating increased effort to breathe due to respiratory distress.