A nurse is assessing a child who is in a sickle cell crisis. Which of the following findings should the nurse expect?
Constipation
Pain
High fever
Bradycardia
The Correct Answer is B
During a sickle cell crisis, the child experiences severe pain due to the sickled red blood cells blocking blood flow in the vessels, leading to tissue ischemia and infarction. Pain is the hallmark symptom of sickle cell crisis and can occur in various parts of the body, such as the abdomen, chest, back, joints, and extremities.
A. Constipation is not a common symptom of sickle cell crisis. It may be associated with other conditions but is not directly related to sickle cell crisis.
C. High fever is not a typical finding in sickle cell crisis. Fever may occur due to infections, which individuals with sickle cell disease are at increased risk of developing, but it is not a direct symptom of the crisis itself.
D. Bradycardia (slow heart rate) is not commonly associated with sickle cell crisis. Tachycardia (rapid heart rate) may occur in response to pain, but bradycardia is not a typical finding.
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Correct Answer is C
Explanation
Infants with gastroesophageal reflux should be placed in an infant seat or an upright position after feedings to help prevent regurgitation and aspiration of stomach contents into the airway. Placing the infant in an upright position facilitates gravity-assisted movement of stomach contents down and away from the esophagus, reducing the likelihood of reflux. It is essential to ensure that the infant seat is appropriate for the child's age and size and that the infant is safely secured within it.
The other options are not recommended for infants with gastroesophageal reflux:
When caring for an infant with gastroesophageal reflux (GER), the nurse should place the infant in an infant seat or an upright position following feedings. Placing the infant in an upright position helps to reduce the risk of reflux and regurgitation. Gravity can assist in keeping the stomach contents from flowing back into the esophagus, reducing the potential for discomfort and reflux symptoms.
The other options are not recommended for an infant with GER:
A. Placing the infant in a prone position (lying on the stomach) after feedings can increase the risk of choking and aspiration. It is essential to avoid this position, especially after feeding, to reduce the risk of reflux and its complications.
B. Placing the infant on his left side is not the preferred position for GER management. While the left side is often recommended for sleeping to reduce the risk of sudden infant death syndrome (SIDS), it is not specifically indicated for GER management after feedings.
D. Placing the infant on his right side is also not the preferred position for GER management after feedings. The right side does not provide the benefits of an upright position in reducing the risk of reflux and regurgitation.
Correct Answer is B
Explanation
In this scenario, the infant has a heart rate of 190/min and a fever of 40°C (104°F). Fever in infants can cause an increase in heart rate, which is a normal physiological response to elevated body temperature. Fever is the body's way of responding to an infection or illness, and it triggers various physiological changes, including an increase in heart rate. This helps the body to circulate blood and deliver immune cells to fight off the infection.
The other options are not accurate or relevant to the infant's current condition:
A. "This is within the expected range for your baby." - A heart rate of 190/min is above the normal expected range for a 2-month-old infant, which is typically between 120 to 160 beats per minute. This response would not address the elevated heart rate and fever.
C. "As your baby begins to fall asleep, his heart rate will decrease." - While heart rate may decrease during sleep, it does not explain the elevated heart rate and fever observed in this situation.
D. "Your baby's heart is beating fast in an attempt to cool down his body." - While tachycardia (fast heart rate) can be associated with increased metabolic demands during fever, the main reason for the increased heart rate in this case is the fever itself, not the body's attempt to cool down. Fever is a response to infection or illness and can cause an increase in heart rate as part of the body's normal immune response.
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