A nurse is assisting with caring for an infant immediately postoperative following a cleft lip repair. Which of the following actions should the nurse take?

Choice A rationale:
Decrease daily oral fluid intake. Rationale: This choice is not appropriate for a client experiencing a vaso-occlusive crisis in sickle cell anemia. In this crisis, there is a risk of dehydration due to increased fluid loss, and decreasing oral fluid intake would exacerbate this issue. Adequate hydration is important to prevent further sickling of red blood cells and maintain organ perfusion.
Choice B rationale:
Maintain bed rest to prevent hypoxemia. Rationale: This is the correct choice. During a vaso-occlusive crisis in sickle cell anemia, blood flow to certain tissues is restricted, leading to tissue hypoxia and pain. Bed rest is recommended to reduce metabolic demands and oxygen consumption, helping to prevent further tissue damage and improve oxygenation. It also reduces the risk of complications such as thrombosis and respiratory compromise.
Choice C rationale:
Apply cold compresses to painful joints. Rationale: Applying cold compresses is not a recommended intervention for vaso-occlusive crisis in sickle cell anemia. Cold can exacerbate vasoconstriction and further compromise blood flow to the affected tissues. Warm compresses or warm baths might be more appropriate to promote vasodilation and alleviate pain.
Choice D rationale:
Administer meperidine to eliminate a fever. Rationale: Administering meperidine solely to eliminate a fever is not the primary focus of care for a vaso-occlusive crisis. The priority is to manage pain and improve tissue perfusion. Meperidine is an opioid analgesic that can be used to manage severe pain associated with sickle cell crises, but it should be given with caution due to the risk of respiratory depression and the potential for addiction.

Choice A rationale:
Sun protection is necessary even when using self-tanning creams. Self-tanning creams do not provide protection against the harmful effects of ultraviolet (UV) radiation. Adolescents should be educated about the importance of using sunscreen to prevent skin damage and reduce the risk of skin cancer.
Choice B rationale:
The risk of injury from firearms does not necessarily decrease as children enter adolescence. Adolescents may still lack proper judgment and decision-making skills, making them susceptible to accidents and injuries related to firearms. Educating adolescents about firearm safety and promoting responsible firearm storage is essential.
Choice C rationale:
(Correct Choice) Driving skills can indeed be impaired when friends are present. Teenagers often face distractions while driving, especially when friends are in the car. Peer pressure and social interactions can divert their attention from the road, leading to an increased risk of accidents. Educating adolescents about the importance of focused and responsible driving can help reduce this risk.
Choice D rationale:
Medroxyprogesterone, a form of hormonal contraception, does not provide protection against gonorrhea. It offers contraception by preventing ovulation and altering the cervical mucus to impede sperm penetration. However, it does not offer any protection against sexually transmitted infections (STIs). Adolescents should be educated about safe sex practices to prevent STIs.