A nurse is caring for a newly admitted child who has cystic fibrosis. For which of the following members of the interprofessional team should the nurse initiate a referral?

A. Continuous monitoring of oxygen saturation is crucial in a vaso-occlusive crisis to detect any signs of hypoxia early, which could exacerbate the crisis and lead to more severe complications. This is important for assessing respiratory status, especially in patients with sickle cell disease who may be at risk for acute chest syndrome.

B. Oral intake should not be restricted during a vaso-occlusive crisis as hydration is important for maintaining adequate blood flow and preventing dehydration.

C. Hydroxyurea is used to reduce the frequency of painful crises in patients with sickle cell disease. It works by increasing the production of fetal hemoglobin, which can help prevent sickle cell crises.

D. Meperidine (Demerol) is an opioid analgesic commonly used to manage severe pain associated with sickle cell crises.

E. Vaccination is important in preventing infections, which can trigger or worsen a vaso-occlusive crisis in individuals with sickle cell disease. Ensuring the pneumococcal vaccine is current helps protect the adolescent from potential infections.

F. Placing the client on strict bed rest can increase the risk of thrombosis and impair circulation.

G. Folic acid supplementation is often recommended for patients with sickle cell disease to support red blood cell production and prevent folate deficiency, which can worsen anemia.

H. Cold compresses are not recommended as they can cause vasoconstriction, worsening the pain and sickling in vaso-occlusive crises. Warm compresses are generally preferred.

A. Administering vaccines prior to discharge may not be appropriate for a child with neutropenia as they have a compromised immune system, and live vaccines should be avoided.
B. Avoiding raw fruits and vegetables in the child's diet is essential because raw produce may harbor bacteria that could potentially lead to infections in a child with neutropenia. Cooked fruits and vegetables are safer options.
C. Bathing the child every other day may be appropriate to maintain cleanliness, but it is not specifically related to neutropenia management.
D. Obtaining the child's rectal temperature once daily is important for monitoring for fever, which can be a sign of infection in a neutropenic child. However, dietary precautions to prevent bacterial exposure are more directly related to managing neutropenia.