A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
Instruct the parent to ensure the pneumococcal vaccine is current.
Give oral hydroxyurea.
Monitor oxygen saturation continuously.
Place the client on strict bed rest.
Apply cold compresses to the affected joints.
Administer meperidine IV for pain.
Correct Answer : A,B,C,D,H
A. Instruct the parent to ensure the pneumococcal vaccine is current.
This is a preventive measure to reduce the risk of infections in individuals with sickle cell disease.
B. Give oral hydroxyurea.
Hydroxyurea is used to decrease the frequency of pain episodes in sickle cell disease.
C. Monitor oxygen saturation continuously.
Continuous monitoring of oxygen saturation is important to detect any potential respiratory complications.
D. Place the client on strict bed rest.
Bed rest helps to reduce the metabolic demands on the body and promotes healing.
E. Restrict oral intake.
During a sickle cell crisis, it's generally not necessary to restrict oral intake unless there are specific indications to do so, such as severe abdominal pain or vomiting that prevents the child from tolerating oral feeds.
F. Apply cold compresses to the affected joints. Administer meperidine IV for pain.
Cold compresses may exacerbate vaso-occlusion, and meperidine is not the first-line choice for pain management in sickle cell crisis due to potential neurotoxicity.
G. Administer meperidine IV for pain.
Meperidine has a relatively short duration of action, which may necessitate frequent dosing. This can lead to more fluctuations in pain control.
H. Administer folic acid as prescribed.
Folic acid supplementation is often recommended for individuals with sickle cell disease to support red blood cell production.
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Related Questions
Correct Answer is B
Explanation
A. A child with impetigo has a contagious skin infection. It would not be appropriate to room them with a preschooler who has just had surgery, as this could increase the risk of post-operative infection.
B. Correct. A child with a fractured left femur does not have a contagious condition that would pose a risk to the preschooler following Wilms' tumor removal. This would be an appropriate roommate.
C. A child with viral pneumonia has a contagious respiratory infection. This could put the preschooler at risk of developing a respiratory infection, which could be especially dangerous after surgery.
D. A child with cellulitis of the right radius has a contagious skin infection. It would not be appropriate to room them with a preschooler who has just had surgery, as this could increase the risk of post-operative infection.
Correct Answer is A
Explanation
A. Toddlers with a history of lead poisoning are at risk for developmental delays.
Developmental testing can help identify any delays that may require intervention or support.
B. Lead absorption is not related to iron intake. However, a diet rich in iron can help reduce the absorption of lead.
C. Blood testing, not stool testing, is the primary method for assessing lead levels. Blood lead levels provide the most accurate information about lead exposure.
D. While lead poisoning can cause changes in skin color in severe cases, it is not the primary assessment for lead exposure. Blood lead levels and developmental testing are more indicative of lead poisoning.
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