A nurse is preparing to develop a plan of care for a school-aged child who has been diagnosed with sickle cell anemia. Which of the following findings should the nurse include in the plan of care?

Choice A reason: Pyloric stenosis is a condition in which the muscle at the outlet of the stomach (the pylorus) becomes thickened and obstructs the passage of food into the small intestine. It usually occurs in infants between 2 and 8 weeks of age, and is more common in males. The main symptoms are projectile vomiting after feeding, dehydration, weight loss, and a palpable olive-shaped mass in the right upper quadrant of the abdomen.

Choice B reason: Gastroesophageal reflux is a condition in which the lower esophageal sphincter fails to close properly, allowing the stomach contents to flow back into the esophagus. It is common in infants, especially those who are bottle-fed, and usually resolves by 12 months of age. The main symptoms are regurgitation, spitting up, irritability, and poor weight gain.

Choice C reason: Celiac disease is a condition in which the immune system reacts to gluten, a protein found in wheat, barley, and rye, and damages the lining of the small intestine. It can affect people of any age, but is usually diagnosed in childhood. The main symptoms are diarrhea, abdominal pain, bloating, weight loss, and failure to thrive.

Choice D reason: Lactose intolerance is a condition in which the body lacks the enzyme lactase, which is needed to digest lactose, a sugar found in milk and dairy products. It can affect people of any age, but is more common in adults and certain ethnic groups. The main symptoms are diarrhea, gas, bloating, and abdominal cramps after consuming lactose-containing foods.

Choice A reason: Epiglottitis is a life-threatening condition that causes inflammation and swelling of the epiglottis, the flap of tissue that covers the entrance to the trachea. It can block the airway and cause respiratory distress. The signs and symptoms of epiglottitis include drooling, dysphagia, dysphonia, high fever, and tripod position. Epiglottitis is rare in infants and more common in children aged 2-6 years.

Choice B reason: Bronchiolitis is a viral infection that causes inflammation and mucus production in the bronchioles, the smallest airways in the lungs. It can impair gas exchange and cause respiratory distress. The signs and symptoms of bronchiolitis include sneezing, coughing, nasal congestion, wheezing, tachypnea, retractions, and apneic spells. Bronchiolitis is common in infants and children under 2 years of age, especially during the winter months.

Choice C reason: Influenza is a viral infection that affects the respiratory system. It can cause fever, chills, headache, muscle aches, fatigue, sore throat, cough, and nasal congestion. Influenza can also lead to complications such as pneumonia, otitis media, and sinusitis. Influenza is common in children and adults of all ages, especially during the flu season.

Choice D reason: Croup is a viral infection that causes inflammation and narrowing of the larynx and trachea. It can cause a characteristic barking cough, hoarseness, stridor, and respiratory distress. Croup is common in children aged 6 months to 3 years, especially during the fall and winter months.