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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Related Questions
Correct Answer is B
Explanation
A. Evaluate the child's self-esteem. Self-esteem evaluation is important in general nursing care but is not a specific intervention for managing urinary tract infections.
B. Encourage frequent voiding. Frequent voiding helps to flush out bacteria from the urinary tract and prevents stasis, which can reduce the risk of urinary tract infections.
C. Administer an antidiuretic. Antidiuretics reduce urine output and are not typically used in the treatment of urinary tract infections, which require adequate urine flow to flush out bacteria.
D. Restrict fluids. Adequate hydration is important in managing urinary tract infections to promote urine flow and help flush out bacteria. Fluid restriction is not appropriate unless otherwise indicated.
Correct Answer is C
Explanation
A. Test the urine for ketones. While testing for ketones can be part of illness management in diabetes, it is not as immediate an action as contacting a healthcare provider when blood glucose levels are very high.
B. Withhold insulin dose if feeling nauseous. Insulin should not be withheld due to nausea. It is important to maintain insulin to control blood glucose levels even when feeling unwell. Adjustments to insulin may be necessary based on blood glucose levels and food intake.
C. Notify the provider if blood glucose levels are over 350 mg/dL. Blood glucose levels over 350 mg/dL are concerning and may indicate the need for medical intervention to prevent complications like diabetic ketoacidosis. The healthcare provider should be notified.
D. Limit fluid intake during meal time. Adequate fluid intake is important, especially when blood glucose levels are high, to help prevent dehydration and facilitate glucose clearance. Limiting fluids is not appropriate.
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