The nurse is instructing the parents of a child with sickle cell anemia on safety precautions. What should the nurse emphasize during this teaching?
Remind parents that the child should avoid immunizations to prevent the introduction of bacteria into the body.
Suggest the child participate in sports activities without restriction.
Treat upper respiratory infections with over-the-counter medication.
Ensure a consistent and daily intake of adequate fluids to prevent dehydration.
The Correct Answer is D
A. Children with sickle cell anemia should receive all recommended immunizations to protect against infections, which can trigger a sickle cell crisis.
B. Participating in sports should be done with caution, and activities that lead to dehydration or overexertion should be avoided.
C. Over-the-counter medications should be used cautiously and under the guidance of a healthcare provider, as some medications may not be suitable for children with sickle cell anemia.
D. Ensuring adequate hydration is crucial for preventing sickle cell crises. Dehydration can increase blood viscosity, leading to sickling of the red blood cells and subsequent pain and complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
A. Contact precautions are not indicated unless there is an infectious disease concern, which is not mentioned in this scenario.
B. Head circumference is routine for well-baby visits and neurological conditions (e.g., hydrocephalus). It is not related to pyloric stenosis assessment.
C. Regular weighing is crucial to assess for weight loss due to vomiting and dehydration. Monitoring weight helps evaluate the severity of the infant's condition and the effectiveness of ongoing treatment.
D. Tracking intake and output is essential for managing hydration status and ensuring the infant is receiving adequate fluids. It helps in assessing the balance between fluid loss due to vomiting and fluid replacement.
E. This intervention is not appropriate for hypertrophic pyloric stenosis. The primary treatment for this condition is surgical intervention, and feeding changes alone will not resolve the underlying issue.
F. The FACES scale is typically used for older children who can self-report pain. For an infant, alternative pain assessment methods would be used, such as observing behavioral cues.
G. An enema is not indicated for hypertrophic pyloric stenosis and may worsen the infant's condition. The focus should be on hydration and surgical preparation rather than enemas.
Correct Answer is D
Explanation
A. A bulging fontanel indicates increased intracranial pressure or fluid overload, not dehydration. With dehydration, you expect a sunken fontanel.
B. Bradypnea (slow breathing) is not typically associated with dehydration and may indicate other issues.
C. A capillary refill time of 3 seconds suggests delayed perfusion, but it is not as indicative of severe dehydration as other signs.
D. Severity of dehydration is classified by percentage of body weight lost:Severe: ≥10% loss, moderate: 6–9% loss, mild: 3–5% loss. A 13% loss = severe dehydration, which matches the scenario.
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