A nurse is reinforcing teaching with a client diagnosed with osteoarthritis who reports joint pain, swelling, and stiffness. Which of the following client statements indicates understanding of the teaching?

b. Perform passive range-of-motion exercises.

During a vaso-occlusive crisis in sickle-cell disease, blood flow to certain areas of the body may be restricted, leading to pain and tissue damage. Passive range-of-motion exercises can help promote blood circulation and prevent joint stiffness and further complications. These exercises involve gently moving the child's joints through their full range of motion without active participation from the child.

Explanation for the other options:

a. Limit fluid intake during the evening: Fluid intake is important in sickle-cell disease to prevent dehydration and maintain adequate blood flow. Restricting fluid intake during a vaso-occlusive crisis can further contribute to dehydration and may worsen the crisis. It is important to encourage fluid intake unless otherwise instructed by the healthcare provider.

c. Apply cold compresses to painful areas: Cold compresses are not recommended during a vaso-occlusive crisis in sickle-cell disease. Cold temperatures can cause vasoconstriction and further worsen the blood flow to affected areas, leading to increased pain and tissue damage. Warm compresses or warm packs may be used to promote vasodilation and provide pain relief.

d. Provide a low-protein diet: A low-protein diet is not specifically indicated in the plan of care for a vaso- occlusive crisis in sickle-cell disease. Adequate protein intake is important for overall nutritional needs and tissue repair. The focus of nutritional management in sickle-cell disease is usually on a well-balanced diet that includes adequate hydration and appropriate nutrient intake.

In summary, performing passive range-of-motion exercises is an appropriate intervention to include in the

plan of care for a school-age child experiencing a vaso-occlusive crisis in sickle-cell disease.

Echolalia is the repetition of words or phrases spoken by others. In this case, the client is repeating the nurse's question, "How are you?" This is an example of echolalia.

a) "I am lovistrated" is an example of neologism, which is the creation of new words.

b) "Super, trooper, and duper" is an example of clang association, which is the use of words that sound alike but have no logical connection.

d) "Pink spots in Africa" is an example of a thought disorder, which is a disruption in the organization and expression of thoughts.