The nurse is admitting a 6-year-old child with Sickle Cell Anemia who is being admitted for vaso-occlusive crisis.
Exhibits
The nurse is planning the nursing care for this child and anticipates which of the following to be a part of the plan of care for a child in vaso-occlusive crisis? For each potential intervention, click to specify if the intervention is anticipated or contraindicated.

Monitor RLE pulses with vital signs

Administer Oxycodone 3 mg Q3-4 hours PRN for pain

Continue IV NSS bolus @ 67 ml/hour

Decrease 02 to 2 L/min

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"C"}}

Monitor RLE pulses with vital signs:
Anticipated. Regular monitoring of pulses, especially in areas of pain or tenderness, is essential to assess for adequate perfusion and circulation, which can be compromised in vaso-occlusive crisis.
Administer Oxycodone 3 mg Q3-4 hours PRN for pain:
Anticipated. Pain management is crucial in treating vaso-occlusive crises. Continuation of pain medication is necessary to keep the child's pain under control.
Continue IV NSS bolus @ 67 ml/hour:
Anticipated. Hydration is vital in managing a vaso-occlusive crisis as it helps to reduce blood viscosity and prevent further sickling of red blood cells.
Decrease O2 to 2 L/min:
Contraindicated. Maintaining adequate oxygenation is important in managing vaso-occlusive crises to ensure that tissues receive sufficient oxygen and to prevent further sickling of red blood cells. Decreasing oxygen flow can compromise oxygen delivery.

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Correct Answer is B

Explanation

A. This entry only provides vital signs and lacks context regarding the patient's activities or symptoms.
B. This entry is the most complete as it includes the time, activity (basketball practice), symptom (dizziness), absence of loss of consciousness, and relevant detail (no caffeine intake), giving a comprehensive picture of the patient's experience.
C. This entry describes the electrode placement but does not provide any information on activities or symptoms.
D. This entry details the patient's meals but does not include any information on activities or symptoms related to the Holter monitoring.

A. "We can open the capsule and sprinkle it on food." B. "We will be able to stop the medication on weekends and holidays." C. This medication may cause drowsiness, fatigue and dry mouth." D. "It will take 2 to 3 weeks to see the positive effects of this medication."

Correct Answer is B

Explanation

A. Atomoxetine capsules should not be opened and sprinkled on food; they must be swallowed whole. This statement does not indicate a need for further teaching.
B. Atomoxetine is a non-stimulant medication for ADHD that must be taken consistently every day, not just on school days. This statement indicates a misunderstanding and a need for further teaching.
C. Drowsiness, fatigue, and dry mouth are common side effects of atomoxetine. This statement does not indicate a need for further teaching.
D. It is correct that it may take 2 to 3 weeks to see the positive effects of atomoxetine. This statement does not indicate a need for further teaching.

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Naxlex Comprehensive Predictor Exams

The nurse is reviewing 24-hour Holter monitor diaries of various patients. Which of the following entries is the MOST complete?

Correct Answer is B

Explanation

A school aged child with ADHD was recently switched from a methylphenidate to atomoxetine. The nurse recognizes a need for further teaching when the parents make which of the following statements?

Correct Answer is B

Explanation

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