A nurse is caring for a toddler who has a short leg cast. Which of the following findings should the nurse report to the provider?

A. Administer antispasmodics: Antispasmodics are not typically used for vaso-occlusive crisis pain, which is usually due to ischemia and not muscle spasms.

B. Apply ice to joints: Applying ice is not recommended as it can cause vasoconstriction, worsening the sickling of cells and the pain associated with a vaso-occlusive crisis. Heat application is more appropriate to promote circulation.

C. Initiate IV fluids: Correct. Hydration is a key intervention in managing a vaso-occlusive crisis because it helps to decrease the viscosity of the blood and prevent further sickling of cells.

D. Assess for hyperkalaemia: While it is important to monitor electrolyte levels, hyperkalaemia is not directly associated with a vaso-occlusive crisis. The primary focus should be on pain management and hydration.

A. Weight loss of 5%: A 5% weight loss is typically indicative of mild to moderate dehydration, not severe.

B. Sunken anterior fontanelle: A sunken anterior fontanel is a sign of severe dehydration in infants as it indicates significant fluid loss.

C. Produces tears when crying: Producing tears is a sign of adequate hydration. Absence of tears would be more concerning for dehydration.

D. Capillary refill time 3 seconds: A capillary refill time of 3 seconds is at the upper limit of normal for infants. In severe dehydration, capillary refill time would typically be longer than 3 seconds.