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.
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Related Questions
Correct Answer is B
Explanation
Swimming is one of the best sports for people with hemophilia because it strengthens the muscles without putting stress on the joints. Swimming is also recommended by most sports physicians and hematologists for patients with hemophilia.
Choice A is wrong because soccer is a contact sport that can cause injuries and bleeding episodes in people with hemophilia. Soccer is not recommended by most sports physicians or hematologists for patients with hemophilia.
Choice C is wrong because basketball is also a contact sport that can lead to injuries and bleeding episodes in people with hemophilia. Basketball may be safe for young children, but the risk increases with the intensity of the game.
Choice D is wrong because football is a collision sport that can cause severe injuries and bleeding episodes in people with hemophilia. Football is not recommended by most sports physicians or hematologists for patients with hemophilia.
Normal ranges for hemophilia are:
- Mild hemophilia: 5% to 40% of normal clotting factor
- Moderate hemophilia: 1% to 5% of normal clotting factor
Severe hemophilia: less than 1% of normal clotting factor
Correct Answer is A
Explanation
This is a normal respiratory change in pregnancy caused by elevated levels of estrogen. Estrogen increases blood flow and causes the nasal mucosa to swell, leading to congestion and nosebleeds. This condition is called pregnancy rhinitis and affects up to 20% of pregnant women.
Choice B is wrong because this is not an abnormal cardiovascular change, and the nosebleeds are not an ominous sign. They are usually harmless and do not affect the pregnancy outcome.
Choice C is wrong because there is no evidence that the woman is a victim of domestic violence.
This is a serious accusation that should not be made without proper assessment and screening.
Choice D is wrong because there is no indication that the woman has been using cocaine intranasally. Cocaine use can cause nasal damage and bleeding, but it can also have other signs and symptoms such as agitation, euphoria, dilated pupils, increased heart rate and blood pressure, and risk of miscarriage or preterm labor.
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