A nurse is caring for a 3-year-old child.

Exhibits

For each of the flowing findings, click to specify if the finding is consistent with acute laryngotracheobronchitis or pneumonia. Each finding may support more than one disease process

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.

A. The child's throat pain increasing is expected post-tonsillectomy and can be managed with pain medication. While important to address, it is not the priority in this situation.
B. The child refusing clear liquids may indicate discomfort or difficulty swallowing, but it is not as immediately concerning as other assessment findings.
C. The child crying often may be a response to pain or discomfort but does not indicate a physiological problem requiring immediate attention.
D. The child swallowing frequently is a priority finding because it could indicate bleeding, which is a significant complication after tonsillectomy and requires immediate intervention to prevent further complications or deterioration in the child's condition.