A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching?

"Offer fluids to your child multiple times every day.

"Restrict outdoor play activity to 1 hour per day.

"Monitor your child's temperature daily."

"Apply cold compresses when your child expresses pain

Answer and Explanation

The Correct Answer is A

Children with sickle cell anemia are prone to dehydration, which can worsen the sickling of red blood cells and trigger a sickle cell crisis. Therefore, it is essential to maintain good hydration to prevent crises. Offering fluids to the child multiple times every day helps to keep them well-hydrated.
Option B is not necessary unless there is a specific medical reason to restrict outdoor play. Regular play is essential for a child's physical and emotional development.
Option C is important, but it is not specific to discharge teaching after an acute crisis episode. Monitoring the child's temperature daily is essential to detect early signs of infection, which can be a trigger for sickle cell crises.
Option D is not recommended because applying cold compresses can cause vasoconstriction and may worsen pain in children with sickle cell anemia. Heat therapy, warm compresses, or a warm bath are more appropriate for pain relief during a sickle cell crisis. However, pain management should be discussed with the healthcare provider to ensure the most appropriate approach for the individual child's needs.

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Correct Answer is C

Explanation

A. Gastrointestinal:

Kawasaki disease primarily affects blood vessels, and the gastrointestinal system is not the main target of this condition. While gastrointestinal symptoms can occur as part of the overall inflammatory response, such as abdominal pain, vomiting, or diarrhea, they are not the primary focus of concern in Kawasaki disease. The most critical system to monitor in Kawasaki disease is the cardiovascular system, specifically the coronary arteries.

B. Respiratory:

The respiratory system is not the primary system affected by Kawasaki disease. While respiratory symptoms can occur as part of the overall inflammatory response and fever associated with the disease, such as coughing or runny nose, they are not the main concern in Kawasaki disease. The primary system to monitor in this condition is the cardiovascular system, especially the coronary arteries.

C. Cardiovascular:

This is the correct answer. Kawasaki disease is primarily a vasculitis (inflammation of blood vessels) that affects various blood vessels, including the coronary arteries. The inflammation of the coronary arteries can lead to coronary artery aneurysms and other cardiac complications. Monitoring the cardiovascular system is essential to detect any signs of coronary artery involvement and ensure timely intervention to prevent potential long-term cardiac problems.

D. Integumentary:

The integumentary system (skin) is not the primary focus of Kawasaki disease. While some skin changes can occur during the acute phase of the disease, such as a rash or peeling skin on the hands and feet, these are not the primary concerns. Monitoring the cardiovascular system is critical in Kawasaki disease due to the risk of coronary artery inflammation and potential complications.

A. "Have your child sit with her head tilted forward and hold pressure on her nose for 10 minutes." B. "Apply ice at the base of the nose for 5 min and then check for bleeding. C. "Place your child in a supine position with a pillow under her back." D. "Place your child in a sitting position with her head tilted back

Correct Answer is A

Explanation

For a child with von Willebrand disease experiencing a nosebleed, the nurse should instruct the parent to have the child sit with their head tilted forward slightly (not backward) to prevent blood from flowing down the throat. Applying direct pressure to the nostrils with fingers or using a clean cloth for about 10 minutes will help stop the bleeding.
Option B (applying ice at the base of the nose) is not recommended because ice can cause vasoconstriction, potentially prolonging bleeding in individuals with bleeding disorders.
Option C (placing the child in a supine position with a pillow under the back) is also not recommended, as this can lead to blood flowing down the throat, increasing the risk of aspiration.
Option D (placing the child in a sitting position with her head tilted back) should be avoided as it can lead to blood flowing into the throat and potentially being swallowed or aspirated. This position is generally discouraged for nosebleeds.

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A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a child who has Kawasaki disease. Which of the following systems should the nurse monitor in response to this diagnosis?

Correct Answer is C

Explanation

A nurse receives a call from a parent of a child who has von Willebrand disease and has had a nosebleed. Which of the following instructions should the nurse give to the parent?

Correct Answer is A

Explanation

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