You are preparing a child with sickle cell anemia for discharge after an acute crisis episode. Which of the following instructions is appropriate advice for the care of a child with sickle cell anemia?

Monitor your child’s temperature daily.

Restrict outdoor play to 1 hour per day.

Apply cold compresses when your child expresses pain.

Offer your child fluids frequently to meet their daily fluid goals.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Monitor your child’s temperature daily: Monitoring temperature is important for children with sickle cell anemia as they are prone to infections. A fever can be an early sign of infection, which can be serious for these children. Normal body temperature for children ranges from 36.5°C to 38°C. However, while monitoring temperature is important, it is not the most critical daily advice compared to ensuring adequate hydration.

Choice B Reason:

Restrict outdoor play to 1 hour per day: Limiting outdoor play is not typically necessary unless the child is experiencing extreme fatigue or pain. Physical activity is generally encouraged to maintain overall health, but it should be balanced with rest and hydration. Therefore, this advice is not as crucial as ensuring the child stays hydrated.

Choice C Reason:

Apply cold compresses when your child expresses pain: Cold compresses are not recommended for managing pain in sickle cell anemia. Instead, warm compresses or heating pads are often suggested to help relieve pain by improving blood flow. Cold can cause vasoconstriction, which may worsen pain and complications.

Choice D Reason:

Offer your child fluids frequently to meet their daily fluid goals: Staying well-hydrated is essential for children with sickle cell anemia. Adequate hydration helps prevent sickle cell crises by reducing blood viscosity and promoting better blood flow. This is the most appropriate and critical advice for daily care.

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Correct Answer is B

Explanation

The correct answer is b. 25%.

Choice A: 50%

If both parents are heterozygous for the sickle cell trait (carriers), each child has a 50% chance of inheriting one sickle cell gene from one parent and a normal gene from the other parent. This would make the child a carrier of the sickle cell trait, not someone with sickle cell anemia. Therefore, the chance of having sickle cell anemia is not 50%.

Choice B: 25%

When both parents are carriers of the sickle cell trait (heterozygous), there is a 25% chance that their child will inherit two sickle cell genes (one from each parent), resulting in sickle cell anemia. This is because each parent has one normal hemoglobin gene (A) and one sickle cell gene (S). The possible combinations for their children are AA (normal), AS (carrier), SA (carrier), and SS (sickle cell anemia). The probability of the SS combination is 25%.

Choice C: 75%

A 75% chance is not accurate in this scenario. The 75% figure might be mistakenly considered if one were to add the probabilities of being a carrier (50%) and having sickle cell anemia (25%). However, these probabilities are distinct and should not be combined in this manner.

Choice D: 100%

A 100% chance would imply that every child of the couple would have sickle cell anemia, which is not the case. Since each parent is a carrier, there is only a 25% chance for each child to have sickle cell anemia. The remaining 75% of the time, the child will either be a carrier or have normal hemoglobin.

A. Are given as a last resort because of the threat of addiction. B. Are often ordered but not usually needed. C. Rarely cause addiction because they are medically indicated. D. Are used only if other measures, such as ice packs, are ineffective.

Correct Answer is C

Explanation

Choice A reason:

Opioid analgesics are not given as a last resort solely because of the threat of addiction. While the risk of addiction is a concern, opioids are often necessary for managing severe pain, especially in conditions like sickle cell anemia. The American Society of Hematology guidelines emphasize the importance of effective pain management in sickle cell disease, which often includes the use of opioids. The goal is to manage pain effectively while monitoring for signs of misuse or addiction.

Choice B reason:

Opioid analgesics are often ordered and are usually needed for managing severe pain in patients with sickle cell anemia. Pain episodes in sickle cell disease can be extremely severe and debilitating, requiring potent analgesics like morphine for relief. The management of acute vaso-occlusive pain in sickle cell disease often necessitates the use of opioids to provide adequate pain control.

Choice C reason:

Opioid analgesics, when medically indicated and used under proper medical supervision, rarely cause addiction. The risk of addiction is significantly lower when opioids are used appropriately for pain management in a controlled medical setting. The Mayo Clinic highlights that while opioids have addictive properties, their medical use for pain relief, especially in acute settings, is generally safe when monitored by healthcare professionals.

Choice D reason:

Opioid analgesics are not used only if other measures, such as ice packs, are ineffective. While non-pharmacological measures can be part of pain management, opioids are often necessary for managing severe pain episodes in sickle cell disease. The use of opioids is based on the severity of the pain and the clinical judgment of the healthcare provider.

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You are preparing a child with sickle cell anemia for discharge after an acute crisis episode. Which of the following instructions is appropriate advice for the care of a child with sickle cell anemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A couple comes into the clinic for genetic counseling. Both parents are heterozygous for sickle cell trait. What is the chance each of their children will have sickle cell anemia?

Correct Answer is B

Explanation

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about giving him morphine and it causing addiction. Which is appropriate for the nurse to explain about opioid analgesics?

Correct Answer is C

Explanation

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