After delivery of the placenta, a client's uterus is slow to contract.

 Which of the following is a priority nursing intervention? 

Choice A rationale

The average number of deciduous teeth at 2.5 years of age is 20. The first set of teeth, also known as primary or milk teeth, typically begins to erupt around 6 months of age and all 20 are generally present by the time a child is 3 years old. Twelve deciduous teeth would be an expected number for a younger toddler, around 1 to 1.5 years old.

Choice B rationale

A 2.5-year-old child should have a full set of 20 deciduous teeth. These teeth typically erupt in a predictable sequence, starting with the central incisors and ending with the second molars, which usually appear between 2 and 3 years of age. By 30 months, all 20 primary teeth are typically present and functional for chewing and speech development.

Choice C rationale

This combination is incorrect for a 2.5-year-old. The first permanent teeth, the molars, do not typically begin to erupt until around age 6. A 2.5-year-old would only have deciduous teeth, and the number would be 20. The permanent teeth are not yet present at this age, as the jaw is still growing.

Choice D rationale

This combination is incorrect. A 2.5-year-old has a full set of 20 deciduous teeth. The presence of permanent teeth at this age is not typical. The first permanent teeth erupt between ages 6 and 7. The number of deciduous teeth would also be an incorrect count, as 16 deciduous teeth would be present in a younger toddler.

Choice A rationale

Administering an iron supplement daily is contraindicated unless the child has a diagnosed iron deficiency. Sickle cell anemia is characterized by a hemolytic process, where red blood cells are destroyed prematurely. This leads to a higher-than-normal iron level in the body, as the iron from the destroyed cells is released. Unnecessary iron supplementation can lead to iron overload, which can be toxic to the body.

Choice B rationale

Encouraging long-distance running is not advised for a child with sickle cell anemia. Strenuous physical activity can lead to dehydration and hypoxemia, which are major triggers for a sickle cell crisis. The increased metabolic demand on the body during such activities can promote sickling of red blood cells, leading to vaso-occlusion and severe pain.

Choice C rationale

Limiting the child's fluid intake is a dangerous practice. Dehydration is a major trigger for sickling of red blood cells. When the body is dehydrated, the blood becomes more concentrated, and the red blood cells are more likely to deform into the characteristic sickle shape. Adequate hydration is essential to maintain blood volume and prevent a crisis.

Choice D rationale

An upper respiratory infection can be a trigger for a sickle cell crisis. Infections, especially those that cause fever, increase the body's metabolic rate and can lead to dehydration and acidosis. These physiological changes promote the sickling of red blood cells, which can block blood vessels and cause a painful crisis. Prompt medical attention is crucial to manage the infection and prevent a crisis.