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A nurse is assisting with the discharge of a child who has sickle cell anemia and is recovering from an acute sickle cell crisis. Which of the following instructions should the nurse reinforce with the child's parents?

A.

Have the child eat a high-protein diet.

B.

Monitor the child's temperature twice per day.

C.

Restrict outdoor play activity

D.

Encourage the child to increase his fluid intake.

Answer and Explanation

The Correct Answer is D

A. Have the child eat a high-protein diet. There is no specific requirement for a high-protein diet to manage sickle cell disease. Hydration is more critical in crisis prevention.

B. Monitor the child's temperature twice per day. While monitoring for infection is essential, this is not the most important discharge instruction to prevent crises.

C. Restrict outdoor play activity. While strenuous exercise should be avoided, activity restriction is unnecessary as long as the child stays hydrated and avoids extreme conditions.

D. Encourage the child to increase his fluid intake. Increased fluid intake helps prevent sickling by reducing blood viscosity, which is essential in preventing future crises.


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Related Questions

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,C"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"A"}}

Explanation

Reported pain

  • Leukemia: Possible, as bone pain can occur due to marrow involvement.
  • Sickle Cell Anemia: Yes, common due to vaso-occlusive crises.
  • Hemophilia: No, hemophilia typically causes bleeding rather than pain from blood cell abnormalities.

Bleeding

  • Leukemia: Yes, due to thrombocytopenia.
  • Sickle Cell Anemia: No, bleeding is not typical in sickle cell crises.
  • Hemophilia: Yes, hemophilia is a bleeding disorder due to a clotting factor deficiency.

Temperature

  • Leukemia: Yes, fever can indicate infection due to immunosuppression.
  • Sickle Cell Anemia: Yes, fever can be a sign of infection during crises.
  • Hemophilia: No, hemophilia does not cause fever unless there is an infection.

Bruising

  • Leukemia: Yes, thrombocytopenia can lead to easy bruising.
  • Sickle Cell Anemia: No, bruising is not typical in sickle cell crises.
  • Hemophilia: Yes, due to a clotting factor deficiency, easy bruising is common.

WBC count

  • Leukemia: Yes, often elevated due to immature or abnormal white cells.
  • Sickle Cell Anemia: No, WBC count is usually normal unless there is an infection.
  • Hemophilia: No, WBC count is typically normal in hemophilia.

Correct Answer is ["1610"]

Explanation

Solution:

  1. Convert ounces to milliliters (1 oz = 30 mL):
    • Coffee: 8 oz × 30 mL = 240 mL
    • Juice: 3 oz × 30 mL = 90 mL
    • Soda: 12 oz × 30 mL = 360 mL
  2. Calculate water intake:
    • Initial pitcher: 800 mL
    • Remaining: 200 mL
    • Water intake = 800 mL - 200 mL = 600 mL
  3. Calculate IV fluids intake:
    • IV rate: 40 mL/hr
    • Time: 8 hours
    • IV fluids = 40 mL/hr × 8 hrs = 320 mL
  4. Total intake:
    • 240 mL (coffee) + 90 mL (juice) + 360 mL (soda) + 600 mL (water) + 320 mL (IV) = 1610 mL

Answer: 1610 mL

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