A nurse is contributing to the plan of care for a child who has sickle cell crisis. Which of the following actions should the nurse recommend to include?

Apply cold compresses to the affected areas.

Implement pain management on a PRN basis.

Active range-of-motion (ROM) exercises daily.

Promote hydration with IV and oral fluids.

Answer and Explanation

The Correct Answer is D

A. Apply cold compresses to the affected areas. Cold can cause vasoconstriction, which may worsen the sickling and pain. Heat packs are generally recommended to promote circulation and relieve pain.
B. Implement pain management on a PRN basis. Pain management should be consistent and proactive rather than PRN (as needed). Regular pain control is essential in managing sickle cell crises.
C. Active range-of-motion (ROM) exercises daily. During a crisis, the child should rest and avoid physical activity to prevent further pain and complications. ROM exercises are more appropriate during non-crisis times for maintaining joint function.
D. Promote hydration with IV and oral fluids. Hydration is crucial during a sickle cell crisis as it helps to decrease blood viscosity, reducing the risk of further sickling and vaso-occlusive events.

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Correct Answer is C

Explanation

A. Keep edematous areas moist and covered. Keeping edematous areas moist and covered can worsen edema by trapping moisture and heat, leading to increased swelling.
B. Reach the child to minimize body movement. Minimizing body movement is not appropriate as it can lead to muscle weakness and stiffness. Encouraging gentle movement and position changes is beneficial.
C. Change the child's position frequently. Changing the child's position frequently helps prevent complications such as pressure ulcers and improves circulation, which can aid in reducing edema.
D. Keep the head of the child's bed flat. Elevating the head of the bed can help reduce edema by promoting venous return and reducing fluid accumulation in dependent areas.

A. Excessive hair growth B. Increased appetite C. Fatigue D. Possible infections E. Easy bruising

Correct Answer is ["C","D","E"]

Explanation

A. Excessive hair growth: Hair loss, not excessive hair growth, is a common side effect of chemotherapy.
B. Increased appetite. Chemotherapy often causes nausea, vomiting, and reduced appetite, not an increase in appetite.
C. Fatigue. Fatigue is a common side effect of chemotherapy due to its impact on the body, including reduced blood counts and overall systemic stress.
D. Possible infections: Chemotherapy weakens the immune system, increasing the risk of infections. The nurse will monitor the child for signs of infection and implement measures to prevent them, like proper hand hygiene and maintaining a clean environment.
E. Easy bruising: Chemotherapy can affect blood clotting, making the child more susceptible to bruising. The nurse will educate the parents and child about precautions to minimize bruising risks

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A nurse is contributing to the plan of care for a child who has sickle cell crisis. Which of the following actions should the nurse recommend to include?

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