A nurse is reinforcing teaching with the parents of a school-age child who has a new prescription for albuterol. The nurse should instruct the parents to report which of the following findings as an adverse effect of the medication.

Choice A rationale:
Decrease daily oral fluid intake. Rationale: This choice is not appropriate for a client experiencing a vaso-occlusive crisis in sickle cell anemia. In this crisis, there is a risk of dehydration due to increased fluid loss, and decreasing oral fluid intake would exacerbate this issue. Adequate hydration is important to prevent further sickling of red blood cells and maintain organ perfusion.
Choice B rationale:
Maintain bed rest to prevent hypoxemia. Rationale: This is the correct choice. During a vaso-occlusive crisis in sickle cell anemia, blood flow to certain tissues is restricted, leading to tissue hypoxia and pain. Bed rest is recommended to reduce metabolic demands and oxygen consumption, helping to prevent further tissue damage and improve oxygenation. It also reduces the risk of complications such as thrombosis and respiratory compromise.
Choice C rationale:
Apply cold compresses to painful joints. Rationale: Applying cold compresses is not a recommended intervention for vaso-occlusive crisis in sickle cell anemia. Cold can exacerbate vasoconstriction and further compromise blood flow to the affected tissues. Warm compresses or warm baths might be more appropriate to promote vasodilation and alleviate pain.
Choice D rationale:
Administer meperidine to eliminate a fever. Rationale: Administering meperidine solely to eliminate a fever is not the primary focus of care for a vaso-occlusive crisis. The priority is to manage pain and improve tissue perfusion. Meperidine is an opioid analgesic that can be used to manage severe pain associated with sickle cell crises, but it should be given with caution due to the risk of respiratory depression and the potential for addiction.

Choice A rationale:
Washing the child's pillow in cold water twice monthly is not a relevant instruction for controlling allergens in asthma management. Asthma triggers are often related to airborne allergens such as dust mites, pollen, and pet dander, and focusing on pillow washing alone does not address the broader issue of allergen exposure.
Choice B rationale:
Using a humidifier in the child's bedroom can actually worsen asthma symptoms. Humidifiers can increase the humidity in the air, promoting the growth of mold and dust mites, which are common allergens that can trigger asthma symptoms. Therefore, this instruction is not appropriate for asthma management.
Choice C rationale:
This is the correct answer. Using a damp cloth to dust the child's furniture weekly is a relevant instruction for controlling allergens. Dusting with a damp cloth helps to capture and remove allergens such as dust mites, pollen, and pet dander from surfaces, reducing the child's exposure to these triggers and potentially minimizing asthma symptoms.
Choice D rationale:
Installing carpet in the child's bedroom is not recommended for asthma management. Carpets can harbor dust mites, mold, and other allergens that can exacerbate asthma symptoms. Hard flooring surfaces that can be easily cleaned and do not trap allergens are a better choice for individuals with asthma.