A school-age child is admitted in vaso-occlusive sickle cell crisis.
The child’s care should include which intervention? (Select all that apply.)

Correction of acidosis

Adequate hydration.

Pain management.

Administration of heparin.

Answer and Explanation

Correct Answer : B,C

The child’s care should include adequate hydration and pain management. The management of an acute event of a vaso-occlusive crisis is the use of potent analgesics (opioids), rehydration with normal saline or Ringer’s lactate, treatment of malaria (whether symptomatic or not) using artemisinin combination therapy, and the use of oxygen via face mask, especially for acute chest syndrome.

Choice A is wrong because correction of acidosis is not a specific intervention for the vaso- occlusive crisis.

Acidosis may occur as a complication of sickle cell disease, but it is not the primary cause of the crisis.

Choice D is wrong because the administration of heparin is not recommended for the vaso-occlusive crisis.

Heparin is an anticoagulant that may increase the risk of bleeding and does not prevent or treat the sickling process.

Normal ranges for hemoglobin are 11.5 to 15.5 g/dl for children after 2 years of age.

Normal ranges for reticulocyte count are 0.5% to 1.5% for adults and 0.5% to 2.5% for children.

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Correct Answer is D

Explanation

This pattern is called periodic breathing and it is characterized by 5 to 10 seconds of respiratory pauses followed by 10 to 15 seconds of compensatory rapid respiration. It is a normal phenomenon that occurs primarily in premature infants of more than 24 hours of age. It is usually not of pathologic significance and does not require intervention.

Choice A is wrong because sleep or wakeful apnea is defined as a cessation of breathing for more than 20 seconds or less than 20 seconds with bradycardia or cyanosis.

Choice B is wrong because severe swings in blood pressure are not associated with periodic breathing, but rather with intraventricular hemorrhage or patent ductus arteriosus.

Choice C is wrong because trying to maintain a neutral thermal environment does not affect the respiratory pattern of premature infants.

Normal ranges for respiratory rate in premature infants are 40 to 60 breaths per minute. Normal ranges for oxygen saturation in premature infants are 88% to 92%.

A. “You may need to increase the caloric density of your infant’s formula.”. B. “You should feed your baby every 2 hours.”. C. “You may need to increase the amount of formula your infant eats with each feeding.”. D. “You should place a nasal oxygen cannula on your infant during and after each feeding.”.

Correct Answer is A

Explanation

“You may need to increase the caloric density of your infant’s formula.” This is because infants with heart failure have increased metabolic needs and may not be able to consume enough volume to meet their nutritional requirements. Increasing the caloric density of the formula can help them achieve adequate growth and development without overloading their heart.

Choice B is wrong because feeding the baby every 2 hours may cause fatigue and dehydration. Infants with heart failure should be fed every 3 to 4 hours or on demand.

Choice C is wrong because increasing the amount of formula may cause fluid retention and worsen heart failure. Infants with heart failure should be fed small, frequent amounts of formula.

Choice D is wrong because placing a nasal oxygen cannula on the infant during and after each feeding may not be necessary or beneficial. Oxygen therapy should be prescribed by a physician based on the infant’s oxygen saturation levels and clinical signs of hypoxia.

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A school-age child is admitted in vaso-occlusive sickle cell crisis. The child’s care should include which intervention? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

Premature infants who exhibit 5 to 10 seconds of respiratory pauses followed by 10 to 15 seconds of compensatory rapid respiration are:.

Correct Answer is D

Explanation

The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct?

Correct Answer is A

Explanation

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

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A school-age child is admitted in vaso-occlusive sickle cell crisis.
The child’s care should include which intervention? (Select all that apply.)