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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
A respiratory rate of 10 bpm is significantly lower than the normal range for adults, which is typically 12-20 breaths per minute. This finding suggests respiratory depression, a potential complication of magnesium sulfate administration. Magnesium sulfate, when given intravenously, can lead to respiratory depression, hypotension, and loss of deep tendon reflexes. Monitoring respiratory rate is crucial to detect early signs of respiratory depression, allowing prompt intervention to prevent respiratory failure.
Choice B rationale:
A blood pressure of 148/94 mmHg is elevated and indicates hypertension. While hypertension is a known side effect of magnesium sulfate, a blood pressure reading alone is not specific enough to indicate a complication of treatment. It is essential to consider other vital signs and symptoms for a comprehensive assessment.
Choice C rationale:
Deep tendon reflexes of +2 are within the normal range and do not indicate a complication of magnesium sulfate administration. Hyperreflexia (exaggerated reflexes) is a sign of magnesium toxicity, but +2 reflexes are normal. Monitoring deep tendon reflexes is crucial, but the given value is within the normal range.
Choice D rationale:
An urine output of 70 ml/hour is within the normal range of urine output (30-60 ml/hour) for adults. While monitoring urine output is essential to assess renal function, this value does not indicate a complication of magnesium sulfate administration. Decreased urine output could suggest kidney injury, which is a potential complication of magnesium sulfate, but 70 ml/hour is within the normal range.
Correct Answer is D
Explanation
Choice A rationale:
Bronchoscopy is not the essential test for diagnosing cystic fibrosis. Bronchoscopy is a procedure that allows the healthcare provider to visualize the airways and lungs but is not the primary test for cystic fibrosis diagnosis. Cystic fibrosis is primarily diagnosed through genetic testing and sweat chloride testing.
Choice B rationale:
Serum calcium levels are not specific to cystic fibrosis diagnosis. Serum calcium levels are typically used to assess calcium balance in the body and are not directly related to cystic fibrosis diagnosis.
Choice C rationale:
Urine creatinine levels are not specific to cystic fibrosis diagnosis. Urine creatinine levels are often used to assess kidney function and muscle breakdown but are not diagnostic for cystic fibrosis.
Choice D rationale:
Sweat chloride test is essential in establishing the diagnosis of cystic fibrosis. Cystic fibrosis is characterized by the abnormal transport of chloride across cell membranes, leading to salty sweat. The sweat chloride test measures the amount of chloride in the sweat and is a key diagnostic test for cystic fibrosis. Values above a certain threshold (typically 60 mmol/L) are suggestive of cystic fibrosis.
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