A nurse is assisting with the discharge of a child who has sickle cell anemia and is recovering from an acute sickle cell crisis. Which of the following instructions should the nurse reinforce with the child's parents?
Have the child eat a high-protein diet.
Monitor the child's temperature twice per day.
Restrict outdoor play activity
Encourage the child to increase his fluid intake.
The Correct Answer is D
A. Have the child eat a high-protein diet. There is no specific requirement for a high-protein diet to manage sickle cell disease. Hydration is more critical in crisis prevention.
B. Monitor the child's temperature twice per day. While monitoring for infection is essential, this is not the most important discharge instruction to prevent crises.
C. Restrict outdoor play activity. While strenuous exercise should be avoided, activity restriction is unnecessary as long as the child stays hydrated and avoids extreme conditions.
D. Encourage the child to increase his fluid intake. Increased fluid intake helps prevent sickling by reducing blood viscosity, which is essential in preventing future crises.
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Correct Answer is B
Explanation
A. Thyroid disease: While some thyroid diseases may indirectly contribute to anemia, thyroid disease itself does not directly cause low hemoglobin and hematocrit.
B. Anemia: Low hemoglobin and hematocrit levels indicate anemia, which can be caused by various factors, including blood loss, iron deficiency, or chronic disease.
C. Acute bronchitis: Acute bronchitis typically affects respiratory function and does not directly cause a decrease in hemoglobin or hematocrit.
D. Hemochromatosis: Hemochromatosis is characterized by excess iron in the body, often resulting in elevated rather than decreased hemoglobin and hematocrit.
Correct Answer is C
Explanation
A. Folate: Folate is important for red blood cell production but does not address the Vitamin B12 deficiency seen in pernicious anemia.
B. Vitamin C: Vitamin C does not impact pernicious anemia as it is not involved in Vitamin B12 absorption.
C. Vitamin B12: Pernicious anemia occurs due to a lack of intrinsic factor, which is necessary for Vitamin B12 absorption. After a total gastrectomy, intrinsic factor is no longer produced, requiring Vitamin B12 supplementation.
D. Iron: Iron deficiency anemia is different from pernicious anemia, which specifically requires Vitamin B12 supplementation.