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 A
Explanation
Drying the baby after birth and wrapping the baby in a dry blanket
This prevents evaporative heat loss, which occurs when water on the skin surface evaporates and cools the skin. Evaporative heat loss is especially significant in newborns because they are wet at birth and have a large surface area relative to their body mass.
Choice B is wrong because it addresses convective heat loss, which occurs when air currents blow over the skin and carry away heat.
Convective heat loss can be prevented by keeping the baby out of drafts and away from air conditioners.
Choice C is wrong because it addresses radiant heat loss, which occurs when heat radiates from the skin to cooler objects in the environment.
Radiant heat loss can be prevented by placing the baby away from the outside wall and the windows.
Choice D is wrong because it addresses conductive heat loss, which occurs when heat transfers from the skin to cooler objects in contact with the skin.
Conductive heat loss can be prevented by warming the stethoscope and the nurse’s hands before touching the baby.
Normal body temperature for a newborn is 36.5°C to 37.5°C (97.7°F to 99.5°F).
Correct Answer is B
Explanation
This is because a patent ductus arteriosus is a congenital heart defect that involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close. This causes a continuous machinery-like murmur that can be heard on auscultation.
Choice A is wrong because pulmonary stenosis is a narrowing of the pulmonary valve or artery that obstructs blood flow to the lungs. It causes a systolic ejection murmur that is best heard at the upper left sternal border.
Choice C is wrong because the ventricular septal defect is a hole in the wall between the ventricles that allows blood to flow from the left to the right side of the heart. It causes a loud, harsh holosystolic murmur that is best heard at the left lower sternal border.
Choice D is wrong because coarctation of the aorta is a narrowing of the aorta that reduces blood flow to the lower body. It causes a systolic murmur that radiates to the back and weak or absent femoral pulses.
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