In assessing a 2-year-old boy with croup, the practical nurse (PN) finds that he has become increasingly irritable and has developed tachypnea and resting stridor. Which intervention is best for the PN to implement?

The correct answer is

Choice D rationale:

The practical nurse (PN) should review the client's risk factors for exercise intolerance that impact his quality of life. By doing so, the PN can assess the client's overall health and identify any potential issues that might contribute to his fatigue. This response shows the PN's concern for the client's well-being and is focused on exploring the root cause of his tiredness.

Choice A rationale:

Determining if the client can move to a residential home without lawn maintenance is not appropriate in response to his complaint about feeling tired. This option does not address the underlying issue and assumes the client is unable to care for his own lawn, which may not be the case.

Choice B rationale:

Recommending that the client retires from doing outdoor chores is also not appropriate. It assumes the client's fatigue is solely due to his age and disregards the possibility of other contributing factors that might be addressed.

Choice C rationale:

Advising the client that fatigue is a common characteristic of aging is not a comprehensive response. While fatigue can be related to aging, it is crucial to explore the specific reasons for the client's tiredness before assuming it is solely age-related.

Correct Answer: B. Joint pain.

Choice B rationale:

Joint pain is the most common symptom experienced by individuals during a sickle cell crisis. The misshapen red blood cells can block blood flow to joints, leading to severe pain and inflammation. Joint pain is a hallmark sign of a sickle cell crisis, and managing pain is a critical aspect of caring for these patients.

Choice A rationale:

Decreased hemoglobin is not the expected symptom during a sickle cell crisis. A sickle cell crisis is characterized by sudden and severe pain due to the misshapen red blood cells blocking blood flow and causing tissue damage. While a sickle cell crisis can lead to anemia, the child experiencing the crisis would be more likely to describe pain and not specifically mention decreased hemoglobin.

Choice C rationale:

Infection is not a typical symptom experienced during a sickle cell crisis. While sickle cell disease can increase the risk of infections, the crisis itself primarily manifests as acute pain due to vaso-occlusion.

Choice D rationale:

Fatigue may be experienced by individuals with sickle cell disease, especially during or after a crisis, but it is not the most likely symptom they would describe during a sickle cell crisis. The hallmark symptom of a sickle cell crisis is severe pain.