A nurse in a community clinic is reviewing the laboratory results of four clients. The nurse should identify which of the following sexually transmitted infections is nationally notifiable.

A. Instruct the parent to ensure the pneumococcal vaccine is current.
This is a preventive measure to reduce the risk of infections in individuals with sickle cell disease.

B. Give oral hydroxyurea.
Hydroxyurea is used to decrease the frequency of pain episodes in sickle cell disease.

C. Monitor oxygen saturation continuously.
Continuous monitoring of oxygen saturation is important to detect any potential respiratory complications.

D. Place the client on strict bed rest.
Bed rest helps to reduce the metabolic demands on the body and promotes healing.

E. Restrict oral intake.
During a sickle cell crisis, it's generally not necessary to restrict oral intake unless there are specific indications to do so, such as severe abdominal pain or vomiting that prevents the child from tolerating oral feeds.

F. Apply cold compresses to the affected joints. Administer meperidine IV for pain.
Cold compresses may exacerbate vaso-occlusion, and meperidine is not the first-line choice for pain management in sickle cell crisis due to potential neurotoxicity.
G. Administer meperidine IV for pain.
Meperidine has a relatively short duration of action, which may necessitate frequent dosing. This can lead to more fluctuations in pain control.

H. Administer folic acid as prescribed.
Folic acid supplementation is often recommended for individuals with sickle cell disease to support red blood cell production.

A. Changing positions frequently may be distracting and confusing for the child. It is important to find a comfortable and quiet environment for communication.

B. Exaggerating the pronunciation of words may distort the natural flow of speech and make it more difficult for the child to understand. It is best to speak clearly and at a normal pace.

C. Using light touch when initiating conversation is not effective for a child with hearing loss, as they rely primarily on visual and auditory cues for communication.

D. This is the correct action. Maintaining a neutral facial expression allows the child to observe facial cues and expressions that are important for understanding non-verbal communication. It also helps create a comfortable and natural environment for conversation.