A school-age child is admitted in vaso-occlusive sickle cell crisis. What should be included in the child’s care?

Adequate oxygenation and replacement of factor V

Adequate hydration and pain management

Pain management and administration of heparin

Correction of acidosis

Answer and Explanation

The Correct Answer is B

Choice A reason:

Adequate oxygenation is important in managing vaso-occlusive sickle cell crisis, but the replacement of factor V is not relevant to this condition. Factor V is involved in the blood clotting process, and its replacement is typically associated with bleeding disorders such as hemophilia. Therefore, this choice is not appropriate for managing a vaso-occlusive crisis.

Choice B reason:

Adequate hydration and pain management are critical components of care for a child in vaso-occlusive sickle cell crisis. Hydration helps to reduce the viscosity of the blood, which can prevent further sickling of red blood cells and improve blood flow. Pain management is essential because vaso-occlusive crises are extremely painful and require prompt and effective pain relief, often with opioid analgesics. These measures help to alleviate symptoms and prevent complications.

Choice C reason:

Pain management is indeed a crucial aspect of care for vaso-occlusive sickle cell crisis, but the administration of heparin is not typically part of the treatment. Heparin is an anticoagulant used to prevent blood clots, and it is not indicated for managing vaso-occlusive crises. The focus should be on hydration and pain relief rather than anticoagulation.

Choice D reason:

Correction of acidosis may be necessary in some cases, but it is not the primary focus of care for vaso-occlusive sickle cell crisis. The main goals are to manage pain and ensure adequate hydration to improve blood flow and reduce the risk of further sickling of red blood cells. While addressing acidosis can be part of the overall management, it is not the primary intervention.

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Correct Answer is C

Explanation

The correct answer is c. An excessive destruction of platelets.

Choice A: Diffuse fibrin deposition in the microvasculature

Diffuse fibrin deposition in the microvasculature is not characteristic of immune thrombocytopenia (ITP). This description is more aligned with disseminated intravascular coagulation (DIC), a condition where widespread clotting occurs within the blood vessels, leading to multiple organ damage.

Choice B: Deficiency in the production rate of globin chains

A deficiency in the production rate of globin chains is associated with thalassemia, a genetic blood disorder that affects the production of hemoglobin. This is not related to the pathology of immune thrombocytopenia.

Choice C: An excessive destruction of platelets

An excessive destruction of platelets is the hallmark of immune thrombocytopenia (ITP). In ITP, the immune system mistakenly targets and destroys platelets, which are essential for blood clotting. This leads to a low platelet count and an increased risk of bleeding.

Choice D: Bone marrow failure in which all elements are suppressed

Bone marrow failure in which all elements are suppressed is characteristic of aplastic anemia, a condition where the bone marrow fails to produce sufficient blood cells. This is not related to immune thrombocytopenia.

A. Monitor your child’s temperature daily. B. Restrict outdoor play to 1 hour per day. C. Apply cold compresses when your child expresses pain. D. Offer your child fluids frequently to meet their daily fluid goals.

Correct Answer is D

Explanation

Choice A reason:

Monitor your child’s temperature daily: Monitoring temperature is important for children with sickle cell anemia as they are prone to infections. A fever can be an early sign of infection, which can be serious for these children. Normal body temperature for children ranges from 36.5°C to 38°C. However, while monitoring temperature is important, it is not the most critical daily advice compared to ensuring adequate hydration.

Choice B Reason:

Restrict outdoor play to 1 hour per day: Limiting outdoor play is not typically necessary unless the child is experiencing extreme fatigue or pain. Physical activity is generally encouraged to maintain overall health, but it should be balanced with rest and hydration. Therefore, this advice is not as crucial as ensuring the child stays hydrated.

Choice C Reason:

Apply cold compresses when your child expresses pain: Cold compresses are not recommended for managing pain in sickle cell anemia. Instead, warm compresses or heating pads are often suggested to help relieve pain by improving blood flow. Cold can cause vasoconstriction, which may worsen pain and complications.

Choice D Reason:

Offer your child fluids frequently to meet their daily fluid goals: Staying well-hydrated is essential for children with sickle cell anemia. Adequate hydration helps prevent sickle cell crises by reducing blood viscosity and promoting better blood flow. This is the most appropriate and critical advice for daily care.

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A school-age child is admitted in vaso-occlusive sickle cell crisis. What should be included in the child’s care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which describes the pathology of immune thrombocytopenia?

Correct Answer is C

Explanation

You are preparing a child with sickle cell anemia for discharge after an acute crisis episode. Which of the following instructions is appropriate advice for the care of a child with sickle cell anemia?

Correct Answer is D

Explanation

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