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RN Nursing Care of Children 2019 with NGN
RN Nursing Care of Children 2019 with NGN ( 67 Questions)
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.
History and Physical
A 15-year-old adolescent is admitted for a vaso-occlusive crisis. The parent reports that the adolescent has a low-grade fever and has vomited for 3 days. The adolescent reports having right-sided and low back pain. They also report hands and right knee are painful and swollen. The client reports pain as 8 on a scale of 0 to 10.
The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.
Instruct the parent to ensure the pneumococcal vaccine is current.This is a preventive measure to reduce the risk of infections in individuals with sickle cell disease.
Give oral hydroxyurea.Hydroxyurea is used to decrease the frequency of pain episodes in sickle cell disease.
Monitor oxygen saturation continuously.Continuous monitoring of oxygen saturation is important to detect any potential respiratory complications.
Place the client on strict bed rest.Bed rest helps to reduce the metabolic demands on the body and promotes healing.
​​​​​​Administer meperidine IV for pain. Cold compresses may exacerbate vaso-occlusion, and meperidine is not the first-line choice for pain management in sickle cell crisis due to potential neurotoxicity.
Meperidine has a relatively short duration of action, which may necessitate frequent dosing. This can lead to more fluctuations in pain control.
A. Instruct the parent to ensure the pneumococcal vaccine is current.
This is a preventive measure to reduce the risk of infections in individuals with sickle cell disease.
B. Give oral hydroxyurea.
Hydroxyurea is used to decrease the frequency of pain episodes in sickle cell disease.
C. Monitor oxygen saturation continuously.
Continuous monitoring of oxygen saturation is important to detect any potential respiratory complications.
D. Place the client on strict bed rest.
Bed rest helps to reduce the metabolic demands on the body and promotes healing.
E. Restrict oral intake.
During a sickle cell crisis, it's generally not necessary to restrict oral intake unless there are specific indications to do so, such as severe abdominal pain or vomiting that prevents the child from tolerating oral feeds.
F. Apply cold compresses to the affected joints. Administer meperidine IV for pain.
Cold compresses may exacerbate vaso-occlusion, and meperidine is not the first-line choice for pain management in sickle cell crisis due to potential neurotoxicity.
G. Administer meperidine IV for pain.
Meperidine has a relatively short duration of action, which may necessitate frequent dosing. This can lead to more fluctuations in pain control.
H. Administer folic acid as prescribed.
Folic acid supplementation is often recommended for individuals with sickle cell disease to support red blood cell production.