A nurse is contributing to the plan of care for a child who has sickle cell crisis. Which of the following actions should the nurse recommend to include?

Apply cold compresses to the affected areas.

Implement pain management on a PRN basis.

Active range-of-motion (ROM) exercises daily.

Promote hydration with IV and oral fluids.

Answer and Explanation

The Correct Answer is D

A. Apply cold compresses to the affected areas. Cold can cause vasoconstriction, which may worsen the sickling and pain. Heat packs are generally recommended to promote circulation and relieve pain.
B. Implement pain management on a PRN basis. Pain management should be consistent and proactive rather than PRN (as needed). Regular pain control is essential in managing sickle cell crises.
C. Active range-of-motion (ROM) exercises daily. During a crisis, the child should rest and avoid physical activity to prevent further pain and complications. ROM exercises are more appropriate during non-crisis times for maintaining joint function.
D. Promote hydration with IV and oral fluids. Hydration is crucial during a sickle cell crisis as it helps to decrease blood viscosity, reducing the risk of further sickling and vaso-occlusive events.

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Correct Answer is D

Explanation

A. Offer chicken broth: Chicken broth alone may not provide adequate electrolyte replacement and hydration needed for managing diarrhea-related dehydration.
B. Keep NPO until the diarrhea subsides: NPO status is generally not necessary unless the child is unable to tolerate oral fluids. ORT is preferred to maintain hydration.
C. Start hypertonic IV solution: Hypertonic IV solutions are not typically used for routine management of dehydration from diarrhea in children. ORT is safer and effective.
D. Assist with initiating oral rehydration therapy: Oral rehydration therapy (ORT) is the primary intervention for managing dehydration due to diarrhea in children. It helps replace lost fluids and electrolytes and is the recommended first-line treatment.

A. "I'm tired and want to take a nap." B. "I am scared and I want to go home C. "I am hungry and thirsty." D. "My belly doesn't hurt anymore."

Correct Answer is D

Explanation

A. "I'm tired and want to take a nap." Common in sick children and not necessarily concerning in this context.
B. "I am scared and I want to go home." Emotional response, typical in children facing surgery.
C. "I am hungry and thirsty." Normal sensations and not indicative of the severity of the condition.
D. "My belly doesn't hurt anymore." This statement suggests potential rupture or perforation of the appendix, which can lead to peritonitis and is a surgical emergency. A sudden relief of pain can indicate a worsening condition rather than improvement.

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A nurse is contributing to the plan of care for a child who has sickle cell crisis. Which of the following actions should the nurse recommend to include?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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Correct Answer is D

Explanation

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