A nurse is planning care for an adolescent who has sickle cell anemia. Which of the following immunizations should the nurse include in the plan?

Choice A Reason:

Check oxygen saturation every 4 hr.: While monitoring oxygen saturation is important, in acute epiglottitis, continuous monitoring of oxygen saturation is necessary due to the potential for rapid airway compromise. Intermittent checks every 4 hours may not provide timely information about deteriorating respiratory status.

Choice B Reason:

Obtain a throat culture: While obtaining a throat culture can help identify the causative organism, the priority in acute epiglottitis is securing the airway and stabilizing the child's condition. Attempting a throat culture could provoke agitation or worsen the obstruction due to irritation of the swollen epiglottis.

Choice C Reason:

Initiate droplet isolation precautions: This is an important action because acute epiglottitis is often caused by bacteria, such as Haemophilus influenzae type b (Hib) or Streptococcus pneumoniae, which can spread via respiratory droplets. Isolation precautions help prevent the transmission of the infection to others and protect healthcare workers.

Choice D Reason:

Assist the child into the supine position: In acute epiglottitis, positioning the child supine (lying flat on the back) can worsen the airway obstruction. Keeping the child calm and in a comfortable position that allows easier breathing is important. Sitting the child upright or in a position of comfort that facilitates breathing and minimizes airway obstruction is preferred.

Choice A Reason:

Moving the baby's stuffed animal to the corner of the crib might not address the risk factors for SIDS, and loose bedding or soft objects in the sleep environment can increase the risk.

Choice B Reason:

Having the baby sleep next to the parent in bed might increase the risk of accidental suffocation or entrapment, which are factors associated with an increased risk of SIDS.

Choice C Reason:

Placing the baby on their side to sleep for naps is not recommended because the safest sleep position for infants is on their back. Side sleeping can also increase the risk of the baby rolling onto their stomach, which is a higher risk position for SIDS.

Choice D Reason:

"I will dress my baby in lightweight clothing to sleep." Is correct. Sudden Infant Death Syndrome (SIDS) risk reduction strategies include dressing infants in lightweight clothing to prevent overheating, which is considered a risk factor for SIDS. Ensuring the baby is not excessively bundled up or overheated during sleep can help reduce the risk.