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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?

A.

Encouraging the child to take deep breaths hourly.

B.

Maintaining fluids through an intravenous line.

C.

Beginning active range-of-motion exercises.

D.

Seeing that the child ingests a protein-rich diet.

Answer and Explanation

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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View Related questions

Correct Answer is B

Explanation

Choice A rationale

Encouraging regular activity level as soon as possible is not appropriate for a child with streptococcal pharyngitis. Rest is important to allow the body to recover and prevent complications.

Choice B rationale

Completing the entire course of antibiotics is crucial to prevent complications such as rheumatic fever, which can result from untreated or partially treated streptococcal infections.

Choice C rationale

Expecting the lymph nodes to swell and obstruct the airway is not a typical outcome of streptococcal pharyngitis. While lymph node swelling can occur, it usually does not obstruct the airway.

Choice D rationale

Being aware that the infection may spread and cause a tooth abscess is not a common complication of streptococcal pharyngitis. The primary concern is preventing complications like rheumatic fever and ensuring complete recovery.

Correct Answer is B

Explanation

Choice A rationale

Droplet precautions are used for infections spread through large respiratory droplets, such as influenza, but are not sufficient for measles.

Choice B rationale

Airborne precautions are necessary for measles, as it is spread through small droplets that can remain suspended in the air and travel over long distances.

Choice C rationale

Contact precautions are used for infections spread through direct contact with the patient or their environment, such as MRSA, but are not sufficient for measles.

Choice D rationale

A protective environment is used for patients with compromised immune systems to protect them from infections, not for preventing the spread of infections like measles.

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