A nurse is planning care for an adolescent client who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following interventions is the nurse's priority?

Applying heat to the affected areas

Administering prophylactic antibiotics

Administering the pneumococcal vaccine

Promoting bed rest

Answer and Explanation

The Correct Answer is D

A. Applying heat to the affected areas: In vaso-occlusive crises associated with sickle cell disease, heat packs can be a helpful part of pain management, but they should be used with caution and not in all situations.
B. Administering prophylactic antibiotics: While prophylactic antibiotics are important in preventing infections in sickle cell anemia, this is not the immediate priority during a vaso-occlusive crisis.
C. Administering the pneumococcal vaccine: While vaccination is important, it is not a priority during a vaso-occlusive crisis.
D. Promoting bed rest: The nurse should assist the child to assume a comfortable position so that the child keeps the extremities extended to promote venous return; elevate the head of the bed no more than 30 degrees and avoid putting strain on painful joints.

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

Explanation

A. If the baby vomits, do not administer another dose without consulting the provider to avoid overdosing.
B. There is no expected reduction in urination with GER medications. If decreased urination occurs, it may indicate dehydration or another issue.
C. The baby should not be positioned flat when administering medication to avoid choking or aspiration.
D. Avoid diluting medication in a formula bottle, as the infant may not finish the bottle, leading to incomplete dosing.
E. Administering medication with a syringe ensures accurate dosing and avoids wasting the medicine.

A. Establish a reward system for the child. B. Limit parent visits with the child. C. Keep the door to the child's room open. D. Leave a television on during the night.

Correct Answer is A

Explanation

A. Establish a reward system for the child. Positive reinforcement encourages desired behaviors and helps manage challenging behaviors.
B. Limit parent visits with the child. Parental presence is comforting for children with autism and helps maintain their routine.
C. Keep the door to the child's room open. A calm and controlled environment is essential; an open door can increase stimuli.
D. Leave a television on during the night. Excess noise or stimuli, especially during rest periods, can increase anxiety in children with autism.

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A nurse is planning care for an adolescent client who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following interventions is the nurse's priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is A

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