A nurse is collecting data from a child who has sickle disease and is experiencing a vaso-occlusive crisis. Which of the following findings should the nurse expect?

Pain

Vomiting

Constipation

Bradycardia

Answer and Explanation

The Correct Answer is A

A. Pain: This is the most common and significant symptom of a vaso-occlusive crisis in sickle cell disease. The sickled cells block blood flow, leading to intense pain and tissue ischemia.

B. Vomiting: Vomiting is not a typical finding associated with a vaso-occlusive crisis. While it may occur due to other complications or treatments, it is not directly related to the crisis itself.

C. Constipation: Constipation is not a typical symptom of a vaso-occlusive crisis. It may occur due to decreased activity or medication side effects, but it is not directly linked to the sickle cell crisis.

D. Bradycardia: Bradycardia is not expected in a vaso-occlusive crisis. The crisis usually involves pain and stress, which might increase the heart rate rather than decrease it.

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Correct Answer is B

Explanation

A. Hepatitis B (HBV): The Hepatitis B vaccine is typically completed in the infant stage, and a 5-year-old with up-to-date vaccinations would not need a booster for school entry. This is not included in the pre-kindergarten vaccine schedule.

B. Measles, mumps, and rubella (MMR): The MMR vaccine is part of the pre-kindergarten immunization schedule. A second dose is recommended between ages 4 and 6 to ensure immunity before school entry.

C. Haemophilus influenzae type B (Hib): The Hib vaccine is typically administered to infants and young children, and a 5-year-old with up-to-date immunizations would already be fully vaccinated against Hib. No booster is required at this age.

D. Pneumococcal conjugate vaccine (PCV): The PCV vaccine series is usually completed in infancy, and a 5-year-old with current vaccinations would not require a booster. This vaccine is not part of the pre-kindergarten schedule.

A. Determine if the toddler is voiding. B. Request evaluation of the toddler's serum electrolytes. C. Initiate isotonic fluids with 20 mEq/L potassium chloride. D. Collect a stool sample from the toddler.

Correct Answer is A

Explanation

A. Determine if the toddler is voiding: Assessing urine output is crucial for determining the child’s hydration status. Voiding is an important indicator of kidney function and fluid balance. Ensuring the child is voiding can help determine the severity of dehydration and guide further interventions.

B. Request evaluation of the toddler's serum electrolytes. Evaluating serum electrolytes is important for understanding the extent of dehydration and electrolyte imbalances. However, it is not the immediate first action and should follow the initial assessment of the child's hydration status.

C. Initiate isotonic fluids with 20 mEq/L potassium chloride. Initiating fluid therapy is crucial but should only be done after assessing kidney function through urine output and evaluating the need for potassium supplementation to avoid complications like hyperkalaemia if the kidneys are not functioning properly.

D. Collect a stool sample from the toddler. Collecting a stool sample is useful for diagnosing the cause of gastroenteritis, but it is not the immediate priority. The focus should first be on assessing hydration status and initiating appropriate fluid therapy.

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A nurse is collecting data from a child who has sickle disease and is experiencing a vaso-occlusive crisis. Which of the following findings should the nurse expect?

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