A nurse receives a call from a parent of a child who has von Willebrand disease and has had a nosebleed. Which of the following instructions should the nurse give to the parent?

"Have your child sit with her head tilted forward and hold pressure on her nose for 10 minutes."

"Apply ice at the base of the nose for 5 min and then check for bleeding.

"Place your child in a supine position with a pillow under her back."

"Place your child in a sitting position with her head tilted back

Answer and Explanation

The Correct Answer is A

For a child with von Willebrand disease experiencing a nosebleed, the nurse should instruct the parent to have the child sit with their head tilted forward slightly (not backward) to prevent blood from flowing down the throat. Applying direct pressure to the nostrils with fingers or using a clean cloth for about 10 minutes will help stop the bleeding.
Option B (applying ice at the base of the nose) is not recommended because ice can cause vasoconstriction, potentially prolonging bleeding in individuals with bleeding disorders.
Option C (placing the child in a supine position with a pillow under the back) is also not recommended, as this can lead to blood flowing down the throat, increasing the risk of aspiration.
Option D (placing the child in a sitting position with her head tilted back) should be avoided as it can lead to blood flowing into the throat and potentially being swallowed or aspirated. This position is generally discouraged for nosebleeds.

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Correct Answer is C

Explanation

A.Factor X is a clotting factor involved in the coagulation cascade. It is not directly related to preventing infections. While clotting factors are essential for hemostasis, they do not play a role in infection prevention.

B. Steroids can suppress the immune response, making the child more susceptible to infections. Therefore, they are not specifically administered to prevent infections

C. In a child with a sickle cell crisis who is hospitalized, preventing infections is crucial due to the increased risk of infections in this condition. Administering immunizations that the patient is scheduled for can help prevent certain infections.

Children with sickle cell disease are at a higher risk of bacterial infections, especially from encapsulated organisms like Streptococcus pneumoniae and Haemophilus influenzae. Vaccines can help protect against these pathogens and reduce the risk of serious infections.

Some of the recommended immunizations for children with sickle cell disease include:

Pneumococcal vaccine: This helps protect against infections caused by Streptococcus pneumoniae, which can cause severe respiratory and bloodstream infections.

Haemophilus influenzae type B (Hib) vaccine: This protects against infections caused by Haemophilus influenzae type B, which can lead to serious illnesses like pneumonia and meningitis.

Meningococcal vaccine: This protects against Neisseria meningitidis, which can cause meningitis and bloodstream infections.

Influenza vaccine: This annual vaccine helps protect against seasonal flu, which can be severe in children with sickle cell disease.

Administering these vaccines according to the recommended schedule helps provide protection against certain infections and can improve outcomes for children with sickle cell disease during hospitalization and beyond. The other options, Factor X, steroids, and PCA morphine, are not specific measures for preventing infections in a child with sickle cell crisis.

D.PCA (patient-controlled analgesia) morphine is used for pain management during a sickle cell crisis. It does not directly prevent infections.

A. "I will keep my baby in an upright position after feedings B. "My baby's formula can be thickened with oatmeal. C. "I should position my baby side-lying during sleep. D. "I will have to feed my baby formula rather than breast milk."

Correct Answer is A

Explanation

A. "I will keep my baby in an upright position after feedings."
Gastroesophageal reflux (GER) is a condition where the stomach contents flow back into the esophagus, which can cause spitting up or regurgitation in infants. Keeping the baby in an upright position after feedings can help reduce the likelihood of reflux episodes. By holding the baby in an upright position for about 30 minutes after feeding, gravity can aid in keeping the stomach contents from flowing back into the esophagus.
The other statements are incorrect or do not address the management of gastroesophageal reflux:
B. "My baby's formula can be thickened with oatmeal." - Thickening formula with oatmeal is not a standard recommendation for managing GER in infants. In some cases, thickening formulas may be recommended, but it should be done under the guidance of a healthcare provider.
C. "I should position my baby side-lying during sleep." A side-lying position is not recommended for sleep in infants, as it increases the risk of sudden infant death syndrome (SIDS). The safe sleep position for infants is on their back.
D. "I will have to feed my baby formula rather than breast milk." - The type of feeding (formula or breast milk) does not directly impact the occurrence of gastroesophageal reflux. Both breast milk and formula can cause reflux in some infants. It is essential to discuss feeding options with a healthcare provider to determine the best approach for the individual infant's needs.

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A nurse receives a call from a parent of a child who has von Willebrand disease and has had a nosebleed. Which of the following instructions should the nurse give to the parent?

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d

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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