A school-aged child is admitted to the hospital with a vaso-occlusive sickle cell crisis. Which measure in the child’s care plan should be given priority?
Encouraging the child to take deep breaths hourly.
Maintaining fluids through an intravenous line.
Beginning active range-of-motion exercises.
Seeing that the child ingests a protein-rich diet.
The Correct Answer is B
Choice A rationale
Encouraging deep breaths hourly can help prevent atelectasis and improve oxygenation, but it is not the priority in managing a vaso-occlusive crisis. The primary issue in a vaso-occlusive crisis is the blockage of blood flow due to sickled cells, leading to pain and potential organ damage. While deep breathing exercises are beneficial, they do not directly address the underlying cause of the crisis.
Choice B rationale
Maintaining fluids through an intravenous line is crucial in managing a vaso-occlusive crisis. Hydration helps to reduce blood viscosity, which can prevent further sickling of red blood cells and improve blood flow. Adequate hydration is essential to minimize the risk of complications such as stroke, acute chest syndrome, and organ damage. Therefore, maintaining IV fluids is a priority intervention in this scenario.
Choice C rationale
Beginning active range-of-motion exercises can help prevent joint stiffness and maintain mobility, but it is not the priority during an acute vaso-occlusive crisis. The primary focus should be on managing pain, ensuring adequate hydration, and preventing complications. Once the acute phase is managed, physical therapy and exercises can be introduced to support long- term health and mobility.
Choice D rationale
Seeing that the child ingests a protein-rich diet is important for overall health and growth, especially in children with chronic conditions like sickle cell anemia. However, during an acute vaso-occlusive crisis, the immediate priority is to manage pain, ensure hydration, and prevent complications. Nutritional support can be addressed once the acute crisis is under control.
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Correct Answer is ["A","C","E"]
Explanation
Choice A rationale
Daytime symptoms occurring more than twice a week is an expected finding in mild persistent asthma. This indicates that the asthma is not well-controlled and requires regular use of a controller medication.
Choice B rationale
Nighttime symptoms occurring approximately twice a month is more characteristic of intermittent asthma, not mild persistent asthma.
Choice C rationale
Minor limitations with normal activity are expected in mild persistent asthma. This indicates that the asthma is affecting the child’s daily activities to some extent.
Choice D rationale
Symptoms that are continuous throughout the day are indicative of severe persistent asthma, not mild persistent asthma.
Choice E rationale
A peak expiratory flow (PEF) greater than or equal to 80% of the predicted value is an expected finding in mild persistent asthma. This indicates that the child’s lung function is relatively well-preserved.
Correct Answer is ["A","B","C","D","E"]
Explanation
A. This stage occurs from birth to 18 months. Infants learn to trust their caregivers to meet their needs. If caregivers are consistent and reliable, infants develop a sense of trust.
B. This stage occurs from 18 months to 3 years. Toddlers learn to do things independently. Success leads to autonomy, while failure results in feelings of shame and doubt.
C. This stage occurs from 3 to 5 years. Children begin to assert control and power over their environment. Success leads to a sense of initiative, while failure results in guilt.
D. This stage occurs from 6 to 11 years. Children learn to cope with new social and academic demands. Success leads to a sense of competence, while failure results in feelings of inferiority.
E. This stage occurs from 12 to 18 years. Adolescents explore their independence and develop a sense of self. Success leads to a strong identity, while failure results in role confusion.