A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.

Exhibits

The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.

Instruct the parent to ensure the pneumococcal vaccine is current.

Give oral hydroxyurea.

Monitor oxygen saturation continuously.

Place the client on strict bed rest.

Apply cold compresses to the affected joints.

Administer meperidine IV for pain.

Answer and Explanation

Correct Answer : A,B,C,D,H

A. Instruct the parent to ensure the pneumococcal vaccine is current.
This is a preventive measure to reduce the risk of infections in individuals with sickle cell disease.

B. Give oral hydroxyurea.
Hydroxyurea is used to decrease the frequency of pain episodes in sickle cell disease.

C. Monitor oxygen saturation continuously.
Continuous monitoring of oxygen saturation is important to detect any potential respiratory complications.

D. Place the client on strict bed rest.
Bed rest helps to reduce the metabolic demands on the body and promotes healing.

E. Restrict oral intake.
During a sickle cell crisis, it's generally not necessary to restrict oral intake unless there are specific indications to do so, such as severe abdominal pain or vomiting that prevents the child from tolerating oral feeds.

F. Apply cold compresses to the affected joints. Administer meperidine IV for pain.
Cold compresses may exacerbate vaso-occlusion, and meperidine is not the first-line choice for pain management in sickle cell crisis due to potential neurotoxicity.
G. Administer meperidine IV for pain.
Meperidine has a relatively short duration of action, which may necessitate frequent dosing. This can lead to more fluctuations in pain control.

H. Administer folic acid as prescribed.
Folic acid supplementation is often recommended for individuals with sickle cell disease to support red blood cell production.

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Correct Answer is C

Explanation

A. Applying warming blankets is important for maintaining the child's body temperature, but it is not the top priority in this situation.

B. Administering an IV bolus may be necessary, but it is not the priority action. The child's airway and breathing take precedence.

C. This is the correct action. In cases of submersion injury, there is a risk of respiratory distress or failure due to aspiration of water. Assisting with intubation helps ensure a patent airway and adequate oxygenation.

D. Obtaining an arterial blood gas (ABG) sample is an important assessment, but it is not the top priority. Ensuring a patent airway and providing adequate oxygenation come first.

A. Assist the child into supine position. B. Obtain a throat culture. C. Initiate droplet isolation precautions. D. Check oxygen saturation every 4 hr.

Correct Answer is C

Explanation

A. Assisting the child into a supine position is contraindicated in acute epiglottitis. This can lead to airway obstruction. The child should be allowed to assume a position of comfort, which is typically sitting up and leaning forward.

B. While obtaining a throat culture may be indicated for diagnostic purposes, it is not the first priority in the care of a child with acute epiglottitis. The immediate concern is ensuring airway patency and providing appropriate respiratory support.

C. This is the correct action. Acute epiglottitis is a potentially life-threatening condition that can rapidly lead to airway obstruction. Initiating droplet isolation precautions helps protect healthcare providers and other patients from potential transmission of the causative organism (often Haemophilus influenzae type B).

D. Checking oxygen saturation every 4 hours is important for monitoring respiratory status, but in the case of acute epiglottitis, continuous monitoring of oxygen saturation is often necessary due to the risk of sudden airway obstruction. This action does not address the immediate priority of ensuring a patent airway.

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A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis. Exhibits The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.

Nursing Test Bank

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Correct Answer is C

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Correct Answer is C

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A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.

Exhibits

The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.