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

choice D. Make a follow-up home visit to parents as soon as possible after the infant’s death. This is because a competent, qualified professional should visit the family at home as soon as possible after the death and provide the family with printed information about SIDS.

Choice A is wrong because explaining how SIDS could have been predicted and prevented is inappropriate.

SIDS cannot be prevented or predicted. Discussions about the cause will only increase parental guilt.

Choice B is wrong because the parents should be asked only factual questions to determine the cause of death. Interviewing parents in-depth concerning the circumstances surrounding the infant’s death may be intrusive and stressful.

Choice C is wrong because parents should be allowed and encouraged to make a last visit with their infant. Discouraging parents from making a last visit with the infant may deprive them of an opportunity to say goodbye and grieve.

A. The child’s fever is usually responsive to antibiotics within 48 hours B. The principal area of involvement is the joints C. Aspirin is contraindicated D. Therapeutic management includes the administration of gamma globulin and aspirin.

Correct Answer is D

Explanation

Therapeutic management includes the administration of gamma globulin and aspirin. This is because Kawasaki disease causes inflammation in the walls of small to medium-sized blood vessels that carry blood throughout the body and can lead to complications such as coronary artery aneurysms. Gamma globulin is an intravenous immunoglobulin that can reduce the risk of these complications, and aspirin can help lower fever and inflammation.

Choice A is wrong because the child’s fever is usually not responsive to antibiotics within 48 hours. Kawasaki disease is not caused by a bacterial infection, so antibiotics are not effective.

Choice B is wrong because the principal area of involvement is not the joints. Kawasaki disease affects mainly the blood vessels, but it can also cause swelling in glands (lymph nodes) and mucous membranes inside the mouth, nose, eyes and throat. Joint pain or swelling may occur, but it is not the main feature of the disease.

Choice C is wrong because aspirin is not contraindicated. Aspirin is part of the standard treatment for Kawasaki disease, along with gamma globulin. However, aspirin should be used with caution and under medical supervision, as it can cause Reye’s syndrome in children with viral infections.

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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

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Explanation

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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.)