A nurse is contributing to the plan of care for a school-age child who has sickle-cell disease and is experiencing a vaso-occlusive crisis. Which of the following should the nurse recommend to include in the plan of care?

Limit ﬂuid intake during the evening

Perform passive range-of-motion exercises.

Apply cold compresses to painful areas.

Provide a low-protein diet

Answer and Explanation

The Correct Answer is B

b. Perform passive range-of-motion exercises.

During a vaso-occlusive crisis in sickle-cell disease, blood ﬂow to certain areas of the body may be restricted, leading to pain and tissue damage. Passive range-of-motion exercises can help promote blood circulation and prevent joint stiﬀness and further complications. These exercises involve gently moving the child's joints through their full range of motion without active participation from the child.

Explanation for the other options:

a. Limit ﬂuid intake during the evening: Fluid intake is important in sickle-cell disease to prevent dehydration and maintain adequate blood ﬂow. Restricting ﬂuid intake during a vaso-occlusive crisis can further contribute to dehydration and may worsen the crisis. It is important to encourage ﬂuid intake unless otherwise instructed by the healthcare provider.

c. Apply cold compresses to painful areas: Cold compresses are not recommended during a vaso-occlusive crisis in sickle-cell disease. Cold temperatures can cause vasoconstriction and further worsen the blood ﬂow to aﬀected areas, leading to increased pain and tissue damage. Warm compresses or warm packs may be used to promote vasodilation and provide pain relief.

d. Provide a low-protein diet: A low-protein diet is not specifically indicated in the plan of care for a vaso- occlusive crisis in sickle-cell disease. Adequate protein intake is important for overall nutritional needs and tissue repair. The focus of nutritional management in sickle-cell disease is usually on a well-balanced diet that includes adequate hydration and appropriate nutrient intake.

In summary, performing passive range-of-motion exercises is an appropriate intervention to include in the

plan of care for a school-age child experiencing a vaso-occlusive crisis in sickle-cell disease.

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Correct Answer is B

Explanation

The correct answer is b. "I will apply petroleum jelly to the penis with each diaper change."

Choice A rationale:

It is incorrect to focus on removing all yellow exudate.A small amount of yellow exudate is normal during the healing process after circumcision.Attempting to aggressively clean it off can irritate the delicate healing tissues and cause discomfort for the baby.
Instead,parents should gently cleanse the area with warm water during diaper changes,allowing any mild exudate to naturally drain.

Choice B rationale:

Applying petroleum jelly with each diaper change is an essential step in promoting healing and preventing discomfort after circumcision.Here's why:
- Protects against moisture:Petroleum jelly forms a barrier that protects the delicate healing tissues from moisture from urine and feces.This helps to prevent irritation and keeps the area clean.
- Reduces friction:The lubricating properties of petroleum jelly reduce friction between the penis and the diaper,which can minimize discomfort and pain for the baby.
- Promotes healing:Petroleum jelly creates a moist environment that promotes healing and reduces scab formation.This helps the circumcision site to heal faster and more comfortably.

Choice C rationale:

While ensuring a proper diaper fit is important for overall hygiene,it's not the most crucial aspect of post-circumcision care.A snug diaper can put unnecessary pressure on the healing penis,potentially causing irritation and discomfort.It's generally recommended to choose a diaper that fits comfortably without being too tight.

Choice D rationale:

Using soap to wash the penis is not recommended during the healing process.Soap can be harsh and drying to the delicate tissues,potentially causing irritation and delaying healing.
Warm water is sufficient for cleansing the area during diaper changes.

A. Wash your newborn's head under a stream of running water. B. Bathe your newborn within 30 minutes after a feeding. C. Start the bath by washing the newborn's diaper area first. D. The bath water should be 100 to 103 degrees Fahrenheit.

Correct Answer is D

Explanation

Answer: D

Rationale:

A) "Wash your newborn's head under a stream of running water": Washing the newborn's head under a stream of running water is not safe due to the risk of startling the baby or causing discomfort. Instead, the head should be gently washed using a damp cloth or sponge.

B) "Bathe your newborn within 30 minutes after a feeding": Bathing a newborn within 30 minutes after feeding is not advisable as it may cause discomfort or spitting up due to the baby's full stomach. It is better to wait for some time after feeding before bathing the baby.

C) "Start the bath by washing the newborn's diaper area first": Starting the bath by washing the newborn's diaper area first is not recommended. The face and head should be washed first to avoid spreading bacteria from the diaper area to other parts of the body.

D) "The bath water should be 100 to 103 degrees Fahrenheit": This is the correct temperature range for a newborn's bath water. It is essential to ensure that the water is warm enough to be comfortable but not too hot, to avoid burns or discomfort. The temperature should be checked with a thermometer or the elbow to ensure it is safe for the baby.

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A nurse is contributing to the plan of care for a school-age child who has sickle-cell disease and is experiencing a vaso-occlusive crisis. Which of the following should the nurse recommend to include in the plan of care?

Nursing Test Bank

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