The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of vaso- occlosive crisis which prescription documented in the child's chart should the nurse question?

A. Positioning for comfort is a common intervention during a vaso-occlusive crisis to alleviate pain.

B. Restricting fluid intake is contraindicated in vaso-occlusive crisis; hydration is crucial to help reduce sickling and improve circulation.

C. Avoiding strain on painful joints is appropriate to prevent exacerbating pain and potential damage.

D. Applying nasal oxygen at 2 liters may be indicated to ensure adequate oxygenation, especially if the child is experiencing any respiratory distress.

A. The WBC count is elevated at 15,000/mm³, which indicates leukocytosis. In a child with leukemia, this could suggest a potential relapse or an ongoing infection, which requires prompt evaluation by the provider.

B. The hemoglobin level is at the lower limit of normal (10 g/dL). This can indicate anemia, which is significant in a child with a history of leukemia and may require further investigation or intervention.

C. While the ongoing upper respiratory infection is concerning, it is less urgent than the other findings. The nurse should monitor this but may not need to report it as a critical finding compared to the child's acute symptoms.

D. The presence of clear breath sounds is expected; however, they should be reported in the context of the child's respiratory distress and the associated findings.

E. An oxygen saturation of 92% on room air is below the normal range and indicates hypoxia. This is a critical finding that requires immediate attention from the provider.

F. Subcostal retractions indicate increased work of breathing and respiratory distress, which is an urgent assessment finding that must be communicated to the provider.

G. While the respiratory rate is relevant, the specific number was not provided, and unless it indicates significant distress or abnormality, it may not be a priority report compared to the other findings.

H. The presence of petechiae is concerning, especially in a child with a history of leukemia. This could indicate thrombocytopenia or another hematological issue, which requires further evaluation by the provider.