A pediatric client in sickle cell crisis comes to the hospital with his mother. When assessing the client, the nurse should expect to find which of the following manifestations?

Constipation

Bradycardia

Pain

Fever

Answer and Explanation

The Correct Answer is C

A. Constipation is not typically associated with sickle cell crisis. While it can occur due to medications or dehydration, it is not a primary symptom of a crisis.

B. Bradycardia is not a typical manifestation of sickle cell crisis. The patient might experience tachycardia due to pain or dehydration.

C. Pain is the hallmark symptom of a sickle cell crisis. The sickle-shaped red blood cells obstruct blood flow, leading to ischemia and severe pain, often in the joints or abdomen.

D. Fever can occur if there is an infection, but pain is the most characteristic finding in a sickle cell crisis.

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Correct Answer is ["A","C","E"]

Explanation

2100: Child brought into the emergency department by their guardians. The child has Acute Lymphoblastic Leukemia (ALL) and is currently in the induction phase of treatment for standard risk. The child received chemotherapy with vincristine 8 days ago and is taking daily oral steroids. Child is alert, crying, and clinging to guardian. Guardians report the child has not had a bowel movement for 5 days.

2100:

Pulse 120/min

Respiratory rate 25/min

Temperature 38.8° C (101.9° F) tympanic

SaO2 96% on room air

2120: Child now asleep in guardian's arms. Respirations unlabored, heart rate regular. Child has a double-lumen central line catheter in the left chest wall. Insertion site is erythematous with a scant amount of purulent drainage.

Rationale:

Temperature of 38.8°C (101.9°F) tympanic: Fever in a child with leukemia is concerning as it may indicate an infection, especially since the child is immunocompromised due to chemotherapy. This needs immediate follow-up and potentially blood cultures to determine the source of infection.

Erythema and purulent drainage at central line insertion site: Purulent drainage and erythema at the central line insertion site suggest a possible infection, such as a catheter-associated bloodstream infection. This requires prompt follow-up, possibly including antibiotic therapy and further investigations to prevent sepsis.

Child has not had a bowel movement for 5 days: Constipation is a common side effect of chemotherapy and oral steroids, but a delay in bowel movements could indicate bowel obstruction or other gastrointestinal issues. This needs to be addressed, and the child may require laxatives or further investigation.

A. "DIC occurs only in school-age children." B. "Risk factors of DIC in children include cancer and chemotherapy.” C. "Lyme disease is a risk factor for DIC." D. "The most common cause of DIC in children is sepsis." E. "We have to treat the underlying cause to fix DIC."

Correct Answer is ["B","D","E"]

Explanation

A. DIC can affect children of all ages, not just school-age children.
B. Risk factors of DIC include cancer and chemotherapy, which can trigger DIC due to the activation of clotting factors.
C. Lyme disease is not typically associated with DIC.
D. The most common cause of DIC in children is sepsis, which leads to widespread clotting and hemorrhage.
E. Treating the underlying cause of DIC, such as sepsis or cancer, is essential to resolving DIC and stopping the clotting cascade.

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A pediatric client in sickle cell crisis comes to the hospital with his mother. When assessing the client, the nurse should expect to find which of the following manifestations?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","C","E"]

Explanation

A nurse is caring for a child diagnosed with disseminated intravascular coagulation (DIC). The child's parents ask the nurse what factors can cause or increase the risk of DIC in children. Which of the following statements should be included in the discussion? (Select all that apply).

Correct Answer is ["B","D","E"]

Explanation

A nurse is prioritizing potential complications that may occur to a pediatric client who has cellulitis. Which of the following is the primary concern?

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