The nurse is teaching parents of a newborn recently diagnosed with sickle cell anaemia. Which interventions will the nurse include in the education? Select all that apply.

Seek medical attention if the newborn has a fever.

Watch out for yellowing of the skin or eyes.

Adhere to the recommended vaccine schedule.

Administer factor VIII replacement as indicated.

Provide oral penicillin V potassium to prevent infection.

Answer and Explanation

Correct Answer : A,B,C,E

Choice A reason: Seeking medical attention if the newborn has a fever is crucial for children with sickle cell anaemia. Fever can be an early sign of infection, and children with sickle cell anaemia are at a higher risk for infections. Prompt medical evaluation and treatment are necessary to prevent severe complications.

Choice B reason: Watching out for yellowing of the skin or eyes (jaundice) is important because it can indicate homolysis, a common issue in sickle cell anaemia where red blood cells break down rapidly. Identifying jaundice early allows for timely medical intervention to address underlying causes and prevent further complications.

Choice C reason: Adhering to the recommended vaccine schedule is essential for protecting children with sickle cell anaemia from preventable infections. Their immune systems are often compromised, making them more susceptible to infections that vaccines can help prevent.

Choice D reason: Administering factor VIII replacement is not relevant to sickle cell anaemia. Factor VIII replacement is a treatment for haemophilia, a different blood disorder. This intervention is not applicable in the context of sickle cell anaemia education.

Choice E reason: Providing oral penicillin V potassium to prevent infection is a standard recommendation for children with sickle cell anaemia. Daily prophylactic penicillin helps reduce the risk of serious infections, particularly from Streptococcus pneumoniae, which can be life-threatening in these patients.

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Correct Answer is A

Explanation

Choice A reason: Scheduling a full neurological evaluation is the appropriate action in this scenario. The sudden regression in the child's ability to walk is a significant concern that requires immediate investigation to rule out any underlying neurological or medical conditions. A full neurological evaluation will help identify any issues such as developmental delays, neuromuscular disorders, or other conditions that may be affecting the child's motor skills. Prompt evaluation and diagnosis are crucial for early intervention and appropriate management.

Choice B reason: Recommending follow-up in 30 days after documenting the regression is not an ideal approach in this situation. Given the severity of the regression in the child's walking ability, waiting for 30 days without further investigation could delay critical diagnosis and treatment. Immediate assessment is necessary to address potential underlying issues and provide timely intervention.

Choice C reason: Questioning the parents about changes in the child's activity schedule is important but should not be the sole action taken. While gathering information about the child's activities and environment can provide valuable context, it does not replace the need for a thorough medical evaluation. The primary concern here is the sudden regression in motor skills, which warrants a full neurological assessment.

Choice D reason: Documenting the findings and scheduling an 18-month well-visit is also not sufficient. While it is essential to document the observed regression, delaying further action until the next routine check-up could result in missed opportunities for early diagnosis and intervention. The priority should be to conduct a neurological evaluation to understand the cause of the regression and take appropriate steps to address it.

A. My baby has a higher risk of developing jaundice. B. This procedure was required because my baby was breech. C. The vacuum was required because I did not dilate past 6 centimetres. D. My baby’s head will be cone-shaped for about 2 months.

Correct Answer is A

Explanation

Choice A reason: This statement indicates the parent's understanding that vacuum-assisted deliveries can sometimes lead to an increased risk of jaundice. The use of a vacuum can cause bruising on the baby's scalp, which can lead to the breakdown of red blood cells, thereby increasing bilirubin levels. Elevated bilirubin levels can cause jaundice in newborns. Recognizing this potential risk and monitoring the baby for signs of jaundice is an essential aspect of post-delivery care.

Choice B reason: Stating that the procedure was required because the baby was breech is incorrect. Vacuum-assisted delivery is typically used in cases where the baby is in a cephalic (head-first) position and there are difficulties in progressing through the birth canal, such as when the mother is exhausted, or the baby needs to be delivered quickly due to fatal distress. Breech presentations often necessitate a caesarean section instead of a vacuum-assisted delivery.

Choice C reason: The assertion that the vacuum was required because the mother did not dilate past 6 centimetres is inaccurate. Vacuum-assisted delivery is not related to cervical dilation but rather to difficulties encountered during the second stage of Labor (pushing phase). The decision to use a vacuum is made when the baby is in the birth canal, and additional assistance is needed to facilitate delivery.

Choice D reason: Stating that the baby’s head will be cone-shaped for about 2 months is also incorrect. While a vacuum-assisted delivery can result in a temporary cone-shaped head (known as "caput succedaneum" or melding), this typically resolves within a few days to weeks after birth. It is not expected to last for two months. Proper education should clarify the temporary nature of the head shape changes.

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The nurse is teaching parents of a newborn recently diagnosed with sickle cell anaemia. Which interventions will the nurse include in the education? Select all that apply.

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