A school-aged child is admitted to the hospital with a vaso-occlusive sickle cell crisis. Which measure in the child's care plan should be given priority?

Encouraging the child to take deep breaths hourly

Maintaining fluids through an intravenous line

Beginning active range-of-motion exercises

Seeing that the child ingests a protein-rich diet

Answer and Explanation

The Correct Answer is B

A. Encouraging deep breathing is important for preventing pulmonary complications but is not the priority in managing a vaso-occlusive crisis.

B. Maintaining hydration through intravenous fluids is the priority as it helps to reduce blood viscosity and prevent further sickling of cells, which is critical in managing a vaso-occlusive crisis.

C. Active range-of-motion exercises are important but are not a priority during an acute vaso-occlusive crisis.

D. A protein-rich diet supports overall health but is not immediately relevant to the acute management of a vaso-occlusive crisis.

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Correct Answer is A

Explanation

A. Recording an upper extremity blood pressure (in the arms) compared to a lower extremity blood pressure (in the legs) can help reveal coarctation of the aorta, as the condition often results in higher blood pressure in the upper body and lower pressure in the lower body.

B. Assessing for femoral pulses is important but may not reveal coarctation of the aorta unless there is significant obstruction.

C. Excessive crying is not a specific indicator of coarctation of the aorta.

D. While a cardiac murmur can be associated with various heart conditions, it is not the most definitive assessment for coarctation of the aorta.

A. Oral intake B. Blood pressure C. Temperature D. Oxygenation E. Gastrointestinal status F. Sputum G. Pain H. Respiratory effort

Correct Answer is ["B","D","E","H"]

Explanation

A. While the child’s oral intake is reduced, it is not as immediately critical as the other findings. However, it should still be monitored and managed.

B. The child’s blood pressure has dropped to 88/48 mm Hg on Day 3, which is significantly lower than the initial value and may indicate hypotension. This could be a sign of worsening condition or dehydration and needs to be reported for further evaluation and intervention.

C. The temperature of 38.1° C (100.6° F) on Day 3 indicates a fever but is lower than the initial admission temperature. It is important but not as critical as the other findings in this scenario.

D. The oxygen saturation has decreased to 88% on room air, which is below the normal range and indicates hypoxemia. This is critical in a patient with pneumonia and cystic fibrosis, and it requires immediate attention to manage respiratory function and oxygenation.

E. The child has passed three large, frothy, foul-smelling stools, which could be indicative of a gastrointestinal complication, possibly related to cystic fibrosis. This change in bowel habits should be reported as it may impact the child’s overall condition and treatment plan.

F. The sputum is thick, yellow, and blood-streaked, which is consistent with the condition but does not require immediate reporting unless there is a significant change in color or consistency.

G. The reported pain level of 4 on a scale of 0 to 10 is moderate but not life-threatening. It should be managed, but it is less urgent compared to other assessment findings.

H. The child is using accessory muscles for respiration and is experiencing dyspnea while at rest, which suggests worsening respiratory distress. This is crucial to report as it reflects the severity of the pneumonia and may need adjustments in the treatment plan.

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A school-aged child is admitted to the hospital with a vaso-occlusive sickle cell crisis. Which measure in the child's care plan should be given priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Coarctation of the aorta demonstrates few symptoms in newborns. What is a important assessment to the nurse make on all newborns to help reveal this condition?

Correct Answer is A

Explanation

A nurse is caring for a school-age child. Exhibits Which of the following assessment findings should the nurse report to the provider? Select the 4 findings that the nurse should report to the provider.

Correct Answer is ["B","D","E","H"]

Explanation

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