A nurse is creating a plan of care for a child who has sickle cell anemia. Which of the following interventions should the nurse include in the plan?

Discourage a high level of fluid intake.

Administer meperidine every 4 hr for pain.

Apply cold compresses to painful, swollen joints.

Observe for indications of hypokalemia.

Answer and Explanation

The Correct Answer is D

Choice A reason: Discouraging a high level of fluid intake is incorrect, as hydration is essential for preventing sickle cell crises and reducing blood viscosity. The nurse should encourage the child to drink at least 1.5 times the normal fluid requirement.

Choice B reason: Administering meperidine every 4 hr for pain is incorrect, as meperidine is not recommended for sickle cell pain due to the risk of neurotoxicity and seizures. The nurse should use other opioids such as morphine or hydromorphone for pain management.

Choice C reason: Applying cold compresses to painful, swollen joints is incorrect, as cold can cause vasoconstriction and worsen the sickling of red blood cells. The nurse should use warm compresses or heating pads to promote vasodilation and blood flow.

Choice D reason: Observing for indications of hypokalemia is correct, as sickle cell anemia can cause hemolysis and potassium loss. The nurse should monitor the child's serum potassium level and watch for signs of hypokalemia such as muscle weakness, cramps, arrhythmias, and constipation.

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Correct Answer is B

Explanation

Choice A reason: Fifth disease is a viral infection that causes a rash on the face and body. It is also known as erythema infectiosum or slapped cheek syndrome. It is not the same as pertussis.

Choice B reason: Whooping cough is a bacterial infection that causes severe coughing spells that end with a whooping sound. It is also known as pertussis or the 100-day cough. It is the correct common name for the disease.

Choice C reason: Chickenpox is a viral infection that causes an itchy rash with blisters. It is also known as varicella. It is not the same as pertussis.

Choice D reason: Mumps is a viral infection that causes swelling of the salivary glands. It is also known as parotitis. It is not the same as pertussis.

A. Emphasize the quantity, rather than the quality, of food consumed. B. Expect that food consumption might not decrease significantly. C. Add fruit juice to the child's diet to increase vitamin intake. D. Have the child remain at the table after meals to increase food intake.

Correct Answer is C

Explanation

Choice A reason: This is not a correct instruction for the nurse to include in the teaching. Emphasizing the quantity, rather than the quality, of food consumed may lead to overeating, obesity, or malnutrition. The nurse should encourage the mother to offer a variety of healthy foods in appropriate portions and avoid forcing or bribing the child to eat.

Choice B reason: This is not a correct instruction for the nurse to include in the teaching. Expecting that food consumption might not decrease significantly may cause the mother to ignore the signs of poor nutrition or growth in the child. The nurse should advise the mother to monitor the child's weight, height, and development regularly and consult the provider if there are any concerns.

Choice C reason: This is a correct instruction for the nurse to include in the teaching. Adding fruit juice to the child's diet can increase the vitamin intake, especially vitamin C, which is important for immune function and wound healing. The nurse should recommend the mother to choose 100% fruit juice and limit the amount to 4 to 6 oz per day.

Choice D reason: This is not a correct instruction for the nurse to include in the teaching. Having the child remain at the table after meals to increase food intake may create a negative association with eating and cause more resistance or frustration. The nurse should suggest the mother to make mealtime a pleasant and relaxed experience and respect the child's appetite and preferences.

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A nurse is creating a plan of care for a child who has sickle cell anemia. Which of the following interventions should the nurse include in the plan?

Nursing Test Bank

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