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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is C
Explanation
Hirschsprung disease is a condition where nerve cells are missing from parts of the intestine, leading to problems with bowel movements. The treatment for Hirschsprung disease often involves surgery to remove the affected portion of the bowel and create a temporary ostomy (stoma). An ostomy is an opening in the abdominal wall through which waste material can pass into an external pouch, bypassing the affected section of the intestine.
The correct statement by the parent that indicates an understanding of the teaching is C. The parent is expressing relief that the ostomy is temporary, meaning it is not a permanent situation. This response indicates that the parent has been informed about the nature of the ostomy and its planned duration, which is an essential aspect of preoperative teaching.
Let's go through the other options and explain why they are not the best choices:
A. "I'm glad my child will have normal bowel movements now." This statement is not accurate because, after the initial surgery with the creation of a temporary ostomy, the child will not have normal bowel movements. The ostomy is created to bypass the affected part of the intestine, and the child's bowel movements will be directed through the ostomy until further surgery is performed to reconnect the intestine.
B. "I want to learn how to use my child's feeding tube as soon as possible." While learning how to use a feeding tube may be relevant for certain medical conditions, it is not specifically related to Hirschsprung disease or the planned initial surgery. Hirschsprung disease primarily affects the bowel and its function, not the child's ability to eat.
D. "I want to learn how to empty my child's urinary catheter bag." Hirschsprung disease does not directly impact the urinary system, so there is no specific reason for the parent to learn how to empty a urinary catheter bag in the context of this condition or the planned surgery.
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