A nurse is caring for a school-age child who has a new prescription for continuous pulse oximetry monitoring. 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:
A 15-year-old client who requests testing for a sexually transmitted infection (STI) is seeking healthcare related to sexual health, which is often considered confidential. In many jurisdictions, minors of a certain age (often 12 or older) have the legal right to consent to STI testing and treatment without parental consent. While education on sexual health and responsible decision-making is important, in this case, the nurse may not need to involve the parent if the legal requirements are met.
Choice B rationale:
This is the correct answer. Minors generally require parental consent for medical procedures, including biopsies. A biopsy involves a medical intervention that can carry risks, and it is important to have informed parental consent for procedures on underage clients.
Choice C rationale:
A 16-year-old client who requires prenatal care for pregnancy is not applicable in this scenario. Prenatal care is focused on managing the health and well-being of a pregnant individual and their developing fetus. The question does not provide information that suggests this situation.
Choice D rationale:
A 13-year-old client who requests contraception advice may have the right to access contraception services without parental consent, depending on local laws and regulations. Many places allow minors to access contraception services confidentially, recognizing the importance of sexual health and preventing unintended pregnancies. However, it's always important for healthcare providers to assess each situation and the applicable legal framework to determine whether parental involvement is required.