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:

"Consume 1,500 to 1,700 calories per day." Caloric needs vary among individuals based on factors like age, sex, activity level, and growth rate. While this calorie range might be suitable for some adolescents, it's not universally applicable. Individual energy needs should be assessed based on various factors.

Choice B Reason:

“Increase the amount of your dietary iron intake." During adolescence, especially in menstruating females, the body's iron requirements increase due to the onset of menstruation and rapid growth. Encouraging adequate intake of dietary iron-rich foods is important to prevent iron deficiency anemia.

Choice C Reason:

"Decrease your vitamin D intake once you start to menstruate." Vitamin D is important for bone health, and menstruation doesn't warrant a decrease in vitamin D intake. Adequate vitamin D intake remains important for bone health, especially during adolescence when bone growth is significant.

Choice D Reason:

"Limit your sodium intake to 3,000 milligrams per day." While excessive sodium intake is a concern, the recommended daily sodium intake varies depending on factors like age and health conditions. For many adolescents, the recommended limit for sodium intake might differ from the specified 3,000 milligrams per day.