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.
Replacement of factor VIII.
Correct Answer : B,C,E
Choice A rationale:
Correction of acidosis is not the primary intervention for vaso-occlusive sickle cell crisis. The crisis primarily involves pain due to the obstruction of blood flow by sickled cells. Correcting acidosis is not a direct treatment for this condition.
Choice B rationale:
Adequate hydration is essential in managing vaso-occlusive sickle cell crisis. Proper hydration helps prevent dehydration, which can worsen the crisis and lead to complications. Hydration helps maintain blood flow and prevent further sickling of red blood cells.
Choice C rationale:
Pain management is a crucial intervention for a child with vaso-occlusive sickle cell crisis. Pain results from tissue ischemia caused by sickled red blood cells. Effective pain management, often with analgesics, helps improve the child's comfort and quality of life during the crisis.
Choice D rationale:
Administration of heparin is not indicated for vaso-occlusive sickle cell crisis. Heparin is an anticoagulant that prevents blood clot formation. In sickle cell crisis, the primary issue is the obstruction of blood flow by sickled cells, not the formation of clots. Administering heparin may not address the underlying problem and can lead to potential complications.
Choice E rationale:
Replacement of factor VIII is not relevant to vaso-occlusive sickle cell crisis. Factor VIII is a protein involved in blood clotting and is primarily used in the treatment of hemophilia, a different condition unrelated to sickle cell crisis.
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Correct Answer is D
Explanation
Choice A rationale:
Facilitate maternal-newborn interaction. Facilitating maternal-newborn interaction is an important aspect of breastfeeding, but it is not the primary purpose of encouraging breastfeeding immediately after an emergency birth. The primary purpose is to initiate the lactation cycle, allowing the newborn to receive essential colostrum, the first milk rich in antibodies and nutrients, which aids in the development of the newborn's immune system.
Choice B rationale:
Stimulate the uterus to contract. While breastfeeding can stimulate uterine contractions due to oxytocin release, the primary purpose of encouraging breastfeeding in this context is not to contract the uterus but to initiate the lactation cycle for the newborn's benefit.
Choice C rationale:
Prevent neonatal hypoglycemia. Breastfeeding can help prevent neonatal hypoglycemia by providing the newborn with a constant supply of nutrients, but the primary purpose immediately after an emergency birth is to initiate the lactation cycle and provide colostrum, not solely to prevent hypoglycemia.
Choice D rationale:
Initiate the lactation cycle. Initiating the lactation cycle is the correct answer because breastfeeding immediately after birth helps the woman's body start producing milk and provides the newborn with colostrum, essential for their health and development. Colostrum is rich in antibodies and nutrients, offering vital protection and nourishment to the newborn.
Correct Answer is B
Explanation
Choice A rationale:
Koplik's spots are small white or bluish-white spots with a red halo that appear inside the mouth on the buccal mucosa. They are a characteristic sign of measles (rubeola). Measles is a highly contagious viral infection characterized by fever, cough, runny nose, and a distinctive red rash. The presence of Koplik's spots is a specific diagnostic feature of measles, making choice A incorrect for this scenario.
Choice B rationale:
Koplik's spots are a classic sign of measles (rubeola). These spots typically appear a few days before the onset of the measles rash and are highly indicative of the disease. Measles is a highly contagious viral infection that spreads through respiratory droplets. It is essential to recognize Koplik's spots as they provide an early clue to the diagnosis of measles, enabling healthcare providers to take appropriate precautions and prevent the further spread of the disease.
Choice C rationale:
Chickenpox (varicella) presents with an itchy rash that progresses to fluid-filled blisters. However, Koplik's spots are not associated with chickenpox. Chickenpox is caused by the varicella-zoster virus and is characterized by a widespread rash, fever, and general discomfort. Koplik's spots are specific to measles and do not occur in chickenpox.
Choice D rationale:
Exanthema subitum, also known as roseola, is a viral illness that primarily affects infants and young children. It is characterized by high fever followed by a rash. However, Koplik's spots are not a feature of roseola. The rash in roseola appears after the fever subsides and is typically pink or red, differentiating it from the small white spots seen in measles.
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