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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A barium enema: A barium enema is both diagnostic and therapeutic for intussusception in many cases. It helps to diagnose the condition by visualizing the telescoped intestine and can also often reduce the intussusception by hydrostatic pressure.
B. IV fluids until the spasms subside: IV fluids are important for managing dehydration and maintaining hydration but do not directly treat intussusception.
C. Immediate surgery: Surgery may be necessary if non-operative reduction methods fail or if there are complications like bowel necrosis or perforation. However, it is not the first-line treatment choice.
D. Gastric lavage: Gastric lavage (stomach pumping) is not indicated for the treatment of intussusception.
Correct Answer is A
Explanation
A. Projectile vomiting after feedings: Projectile vomiting after feedings, especially occurring a short time after feeding, is a classic sign of pyloric stenosis due to obstruction at the pylorus.
B. Absent bowel sounds: Absent bowel sounds may occur in more advanced cases of bowel obstruction but are not specific to pyloric stenosis.
C. Increased sodium level: Increased sodium level is not typically associated with pyloric stenosis.
D. Golf ball-size mass over the left quadrant: A palpable mass in the left quadrant is not a typical finding in pyloric stenosis.
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