A nurse is providing discharge teaching to the parents of a school-age child following surgery and cast application to the right forearm.

Which of the following information is the priority for the nurse to include?

Examine the child for skin irritation at the cast edges.

Restrict the child's strenuous activities for 3 days.

Monitor for pallor or swelling in the child's affected hand.

Use a hair dryer on cool setting to relieve itching.

Answer and Explanation

The Correct Answer is C

A.   Examining the child for skin irritation at the cast edges is important to prevent complications but may not be the priority compared to monitoring for signs of impaired circulation or compartment syndrome.
B.   Restricting the child's strenuous activities for 3 days is important for preventing damage to the cast, but it is not as urgent as monitoring for potential complications.
C.   Monitoring for pallor or swelling in the child's affected hand is the priority to assess for impaired circulation or compartment syndrome, which are potential complications of cast application.
D.   Using a hair dryer on a cool setting to relieve itching is a helpful tip but is not as urgent as monitoring for signs of impaired circulation.

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Correct Answer is A

Explanation

A. Discarding the first voided specimen is necessary to ensure accuracy in a 24-hour urine collection. This helps eliminate any urine that has been in the bladder prior to the start of the collection period.
B. Voiding every hour is not necessary for a 24-hour urine collection. The goal is to collect all urine produced over a 24-hour period, not voiding at set intervals.
C. Cleansing the perineum with a povidone-iodine solution prior to voiding is not typically necessary for a 24-hour urine collection unless specifically instructed by the healthcare provider.
D. Saving the final specimen in a separate container is not necessary for a 24-hour urine collection. All urine produced during the specified collection period should be saved in the same container.

A. Monitor oxygen saturation continuously. B. Restrict oral intake. C. Give oral hydroxyurea. D. Administer meperidine IV for pain. E. Instruct the parent to ensure the pneumococcal vaccine is current. F. Place the client on strict bed rest. G. Administer folic acid as prescribed.

Correct Answer is ["A","C","D","E","G"]

Explanation

A. Continuous monitoring of oxygen saturation is crucial in a vaso-occlusive crisis to detect any signs of hypoxia early, which could exacerbate the crisis and lead to more severe complications. This is important for assessing respiratory status, especially in patients with sickle cell disease who may be at risk for acute chest syndrome.

B. Oral intake should not be restricted during a vaso-occlusive crisis as hydration is important for maintaining adequate blood flow and preventing dehydration.

C. Hydroxyurea is used to reduce the frequency of painful crises in patients with sickle cell disease. It works by increasing the production of fetal hemoglobin, which can help prevent sickle cell crises.

D. Meperidine (Demerol) is an opioid analgesic commonly used to manage severe pain associated with sickle cell crises.

E. Vaccination is important in preventing infections, which can trigger or worsen a vaso-occlusive crisis in individuals with sickle cell disease. Ensuring the pneumococcal vaccine is current helps protect the adolescent from potential infections.

F. Placing the client on strict bed rest can increase the risk of thrombosis and impair circulation.

G. Folic acid supplementation is often recommended for patients with sickle cell disease to support red blood cell production and prevent folate deficiency, which can worsen anemia.

H. Cold compresses are not recommended as they can cause vasoconstriction, worsening the pain and sickling in vaso-occlusive crises. Warm compresses are generally preferred.

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A nurse is providing discharge teaching to the parents of a school-age child following surgery and cast application to the right forearm. Which of the following information is the priority for the nurse to include?

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Naxlex Comprehensive Predictor Exams

A nurse is providing instructions about a 24-hr urine collection to an adolescent client. Which of the following should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis. Exhibits The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.

Correct Answer is ["A","C","D","E","G"]

Explanation

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A nurse is providing discharge teaching to the parents of a school-age child following surgery and cast application to the right forearm.

Which of the following information is the priority for the nurse to include?