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A nurse is planning care for an adolescent client.

Exhibits
Which of the following actions should the nurse plan to take? (Select all that apply.)

Apply cold compresses to the joints

Encourage bedrest

Provide oxygen at 6 min via nasal cannula

Restrict fluid intake to 1,400 mL/day.

Obtain consent for a blood transfusion.

Administer IV fluids.

Perform passive range-of-motion exercises.

Answer and Explanation

Correct Answer : B,E,F

A. Cold compresses may not be appropriate in this case. In sickle cell crises, warmth is typically encouraged to promote circulation and reduce pain, whereas cold can constrict blood vessels and potentially worsen ischemia.

B. Bedrest is appropriate for this client to minimize energy expenditure and allow the body to focus on healing. Pain management is also a priority, and limiting activity can help manage pain levels.

C. While oxygen can be helpful in managing hypoxia, the client’s oxygen saturation is currently 96% on room air, indicating adequate oxygenation. Routine administration of oxygen is not indicated in this scenario.

D. In sickle cell disease, hydration is important to reduce blood viscosity and prevent crises. Therefore, the nurse should encourage adequate fluid intake unless contraindicated.

E. The client has a significantly low hemoglobin level (5 g/dL), which may necessitate a blood transfusion to improve oxygen-carrying capacity and treat anemia. Consent should be obtained as part of the preparation for this intervention.

F. Administering IV fluids is essential for rehydration and improving circulation, which can help alleviate pain and prevent further sickling of cells.

G. While passive range-of-motion exercises can be beneficial, they are generally not recommended during acute pain episodes as they may exacerbate discomfort and pain. The focus should be on pain management and rest.

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Correct Answer is B

Explanation

A. Raising the head of the bed may help with respiratory effort but does not address the underlying issue of decreased responsiveness. Immediate assessment and intervention are necessary.

B. Notifying the healthcare provider is critical as the child’s decreased responsiveness and respiratory rate indicate a potential deterioration in condition that requires prompt medical evaluation.

C. While obtaining an oximeter reading can provide useful information about oxygenation, the priority is to notify the HCP about the change in the child's neurological status.

D. Implementing seizure precautions is important for a child with a brain tumor, but the immediate concern is the change in responsiveness, necessitating HCP notification first.

A. Weighing on the same scale each day B. Testing the urine for glucose levels regularly C. Increasing fluid intake by 50 ml per hour D. Ambulating 3 to 4 times a day E. Complete the course of prescribed antibiotics

Correct Answer is A

Explanation

A. Weighing the child daily on the same scale is critical for monitoring fluid retention and managing edema, which are primary concerns in nephrotic syndrome.

B. Testing urine for glucose levels is not a routine part of nephrotic syndrome management, as glucose levels are not typically affected by this condition.

C. Increasing fluid intake is not advisable in nephrotic syndrome if there is significant edema; fluid management must be tailored to the child's condition.

D. While ambulation is beneficial, it is not as critical as daily weight monitoring in managing nephrotic syndrome.

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A nurse is planning care for an adolescent client. Exhibits Which of the following actions should the nurse plan to take? (Select all that apply.)

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A nurse is planning care for an adolescent client.

Exhibits
Which of the following actions should the nurse plan to take? (Select all that apply.)