A nurse is admitting a child who has erythema infectiosum. Which of the following transmission-based precautions should the nurse initiate?

A. Continuous monitoring of oxygen saturation is crucial in a vaso-occlusive crisis to detect any signs of hypoxia early, which could exacerbate the crisis and lead to more severe complications. This is important for assessing respiratory status, especially in patients with sickle cell disease who may be at risk for acute chest syndrome.

B. Oral intake should not be restricted during a vaso-occlusive crisis as hydration is important for maintaining adequate blood flow and preventing dehydration.

C. Hydroxyurea is used to reduce the frequency of painful crises in patients with sickle cell disease. It works by increasing the production of fetal hemoglobin, which can help prevent sickle cell crises.

D. Meperidine (Demerol) is an opioid analgesic commonly used to manage severe pain associated with sickle cell crises.

E. Vaccination is important in preventing infections, which can trigger or worsen a vaso-occlusive crisis in individuals with sickle cell disease. Ensuring the pneumococcal vaccine is current helps protect the adolescent from potential infections.

F. Placing the client on strict bed rest can increase the risk of thrombosis and impair circulation.

G. Folic acid supplementation is often recommended for patients with sickle cell disease to support red blood cell production and prevent folate deficiency, which can worsen anemia.

H. Cold compresses are not recommended as they can cause vasoconstriction, worsening the pain and sickling in vaso-occlusive crises. Warm compresses are generally preferred.

Answer: Renal scarring and pyelonephritis

Rationale:

The child in this scenario is presenting with symptoms consistent with a urinary tract infection (UTI), which has been a recurring issue for the child due to the history of vesicoureteral reflux (VUR). VUR increases the risk of pyelonephritis, a type of kidney infection, because it allows urine to flow back into the kidneys, potentially leading to infection.

Pyelonephritis is the term used to describe a kidney infection, which can develop from untreated or recurrent UTIs.

Renal scarring is a long-term consequence of recurrent UTIs, especially in the context of VUR. The chronic infections can lead to scarring of the kidney tissue, potentially causing long-term kidney damage or dysfunction.

Acute glomerulonephritis and nephrotic syndrome are not as closely linked to this case. While both involve kidney issues, they do not typically result from recurrent UTIs or VUR in the same direct way.

Polycystic kidney disease is a genetic condition that typically does not relate to recurrent UTIs or VUR in young children.