A school-age child is admitted in vaso-occlusive sickle cell crisis.
The child’s care should include which intervention? (Select all that apply.)
Correction of acidosis
Adequate hydration.
Pain management.
Administration of heparin.
Correct Answer : B,C
The child’s care should include adequate hydration and pain management. The management of an acute event of a vaso-occlusive crisis is the use of potent analgesics (opioids), rehydration with normal saline or Ringer’s lactate, treatment of malaria (whether symptomatic or not) using artemisinin combination therapy, and the use of oxygen via face mask, especially for acute chest syndrome.
Choice A is wrong because correction of acidosis is not a specific intervention for the vaso- occlusive crisis.
Acidosis may occur as a complication of sickle cell disease, but it is not the primary cause of the crisis.
Choice D is wrong because the administration of heparin is not recommended for the vaso-occlusive crisis.
Heparin is an anticoagulant that may increase the risk of bleeding and does not prevent or treat the sickling process.
Normal ranges for hemoglobin are 11.5 to 15.5 g/dl for children after 2 years of age.
Normal ranges for reticulocyte count are 0.5% to 1.5% for adults and 0.5% to 2.5% for children.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
“You may need to increase the caloric density of your infant’s formula.” This is because infants with heart failure have increased metabolic needs and may not be able to consume enough volume to meet their nutritional requirements. Increasing the caloric density of the formula can help them achieve adequate growth and development without overloading their heart.
Choice B is wrong because feeding the baby every 2 hours may cause fatigue and dehydration. Infants with heart failure should be fed every 3 to 4 hours or on demand.
Choice C is wrong because increasing the amount of formula may cause fluid retention and worsen heart failure. Infants with heart failure should be fed small, frequent amounts of formula.
Choice D is wrong because placing a nasal oxygen cannula on the infant during and after each feeding may not be necessary or beneficial. Oxygen therapy should be prescribed by a physician based on the infant’s oxygen saturation levels and clinical signs of hypoxia.
Correct Answer is C
Explanation
Placing eye shields over the newborn’s closed eyes. This is because phototherapy can cause eye damage and irritation to the newborn, so eye protection is essential.
Choice A is wrong because oil-based lotion can increase the absorption of heat and cause burns to the newborn’s skin.
Choice B is wrong because limiting the newborn’s intake of milk can cause dehydration and increase the risk of hyperbilirubinemia.
Choice D is wrong because changing the newborn’s position every 4 hours is not frequent enough to prevent pressure ulcers and ensure even exposure to the light.
Normal ranges for bilirubin levels in newborns are 1 to 12 mg/dL for term infants and 3 to 14 mg/dL for preterm infants. Phototherapy is usually indicated when the bilirubin level exceeds 15 mg/dL for term infants and 10 mg/dL for preterm infants.
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