A nurse is developing a plan of care for an adolescent who is experiencing a vaso-occlusive crisis. The adolescent reports painful joints, a fever, and abdominal pain. Which of the following interventions should the nurse include in the plan?

Administer antispasmodics.

Apply ice to joints.

Initiate IV fluids.

Assess for hyperkalemia.

Answer and Explanation

The Correct Answer is C

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.

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Correct Answer is C

Explanation

a. Mix the medication with the child's favorite food. Mixing medication with a child’s favorite food can be risky as it may alter the taste of the food and cause the child to develop an aversion to that food. Additionally, if the child does not consume the entire portion, they may not receive the full dose of medication.

b. Dilute the medication with 8 oz of water. Diluting medication in a large volume of water is not advisable for a preschooler as it may be difficult for them to drink the entire amount, leading to an incomplete dose. It can also dilute the medication to the point where its efficacy is reduced.

c. Provide an ice pop after administering the medication. Offering an ice pop after administering the medication is a positive reinforcement technique. The ice pop can also help numb the taste buds, reducing the aftertaste of the medication, making it more acceptable for the child.

d. Give 4 oz of milk with the medication.Giving milk with medication is not generally recommended as it can interfere with the absorption of some medications. Additionally, if the medication tastes unpleasant, the child might refuse to drink the milk as well.

A. "I will expect my child to need annual sweat chloride testing" B. "I will have my child chew the pancrelipase medication before eating" C. "I will ensure that my child consumes a high-calorie diet." D. "I will administer dornase alfa every 4 hours for wheezing."

Correct Answer is C

Explanation

A. "I will expect my child to need annual sweat chloride testing." Incorrect. Sweat chloride testing is primarily used for diagnosing cystic fibrosis, not for routine annual monitoring. Once a diagnosis is confirmed, ongoing management focuses on nutritional support, respiratory care, and monitoring for complications.

B. "I will have my child chew the pancrelipase medication before eating." Incorrect. Pancrelipase should not be chewed. It needs to be swallowed whole or sprinkled on acidic food to ensure proper absorption and to avoid irritation of the mouth and esophagus.

C. "I will ensure that my child consumes a high-calorie diet." Correct. Children with cystic fibrosis often require a high-calorie diet due to malabsorption issues and the increased energy expenditure related to their condition. Ensuring adequate caloric intake helps with growth and overall health.

D. "I will administer dornase alfa every 4 hours for wheezing." Incorrect. Dornase alfa (Pulmozyme) is usually administered once or twice daily to help thin mucus in the lungs. It is not typically used every 4 hours or specifically for wheezing.

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A nurse is developing a plan of care for an adolescent who is experiencing a vaso-occlusive crisis. The adolescent reports painful joints, a fever, and abdominal pain. Which of the following interventions should the nurse include in the plan?

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