A nurse is assessing a child who is 2 hr postoperative following a cardiac catheterization and finds the dressing is saturated with blood. Which of the following actions should the nurse take first?

A. While preparing the 3-year-old child for changes in routines is important, it is too general. Providing specific strategies like role-playing with a doll would be more helpful.
B. Providing a doll for the 3-year-old child to imitate parental behaviors is an effective way to help them understand and adjust to the new sibling's arrival. This encourages a sense of involvement and can help alleviate feelings of jealousy or displacement.
C. While telling the 3-year-old child about having a new playmate is positive, it does not offer concrete strategies for preparing the child for the new sibling's arrival.
D. Waiting for the newborn to come home before moving the 3-year-old child from the crib to a bed may not be necessary. The transition from crib to bed can be independent of the newborn's arrival and should be based on the child's readiness.

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.