The nurse is caring for a child in traction with a fractured femur. Which action will the nurse complete while caring for this client?

A. Growth hormone therapy is typically administered daily, not weekly. Parents or caregivers are usually trained to give the injections at home, which encourages adherence and consistent growth hormone levels. Reliance on a home health nurse for weekly administration would be inadequate and inconsistent with standard therapy.

B. Routine urine monitoring is not a standard requirement for somatropin therapy. Monitoring is more focused on growth parameters (height, weight), blood glucose, thyroid function, and potential side effects like edema or joint pain. Proteinuria is not a common concern unless other renal complications exist.

C. Somatropin is a peptide hormone, which is degraded in the gastrointestinal tract if taken orally. Therefore, it must be administered via subcutaneous or sometimes intramuscular injection to ensure proper absorption and therapeutic effect. Parents should be taught proper injection technique, site rotation, needle disposal, and storage of the medication (usually refrigerated).

D. While growth hormone is naturally secreted in a pulsatile manner, and some clinicians may schedule injections in the evening to mimic normal secretion, there is no strict requirement for morning administration before school. Timing is flexible as long as injections are consistent daily, and some children may benefit from evening dosing.

A. This is more characteristic of thalassemia major, where extramedullary hematopoiesis occurs in the facial bones and skull due to chronic severe anemia. Sickle-cell anemia does not typically cause this finding.

B. Skin depigmentation is not a typical manifestation of sickle-cell anemia. Skin changes may occur secondary to ischemia (ulcers) or infection, but generalized depigmentation is unrelated.

C. Children with SCA may experience delayed growth and short stature due to chronic anemia, poor oxygenation, and nutritional deficits, not increased growth.

D. Mild jaundice (yellowing of the sclera) is a common finding in sickle-cell anemia due to chronic hemolysis. Destruction of sickled red blood cells releases bilirubin, which can accumulate in the skin and eyes, leading to scleral icterus. This is a hallmark clinical indicator of ongoing hemolysis.