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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Diabetes insipidus is a disorder of the posterior pituitary gland that causes a deficiency of antidiuretic hormone (ADH). This leads to excessive urination (polyuria) and excessive thirst (polydipsia) as the body tries to balance the fluid loss. These symptoms may be so severe that the child does little other than drink and urinate.
Choice A is wrong because oliguria means decreased urine production and is not associated with diabetes insipidus.
Choice B is wrong because glycosuria means glucose in the urine and is associated with diabetes mellitus, not diabetes insipidus.
Choice C is wrong because nausea and vomiting are associated with inappropriate ADH secretion (SIADH), which causes fluid retention and hyponatremia, not diabetes insipidus.
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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