The nurse is assessing a school-aged child with sickle-cell anemia. Which assessment finding is consistent with this child’s diagnosis?
Slightly yellow sclera.
Depigmented areas on the abdomen.
Enlarged mandibular growth.
Increased growth of long bones.
The Correct Answer is A
Choice A rationale
Slightly yellow sclera, or jaundice, is a common finding in children with sickle cell anemia. The breakdown of sickled red blood cells leads to increased bilirubin levels in the blood, which can cause jaundice. This yellowing is often most noticeable in the sclera of the eyes. Jaundice is a result of hemolysis, a hallmark of sickle cell anemia, where red blood cells are destroyed faster than they can be produced.
Choice B rationale
Depigmented areas on the abdomen are not typically associated with sickle cell anemia. Sickle cell anemia primarily affects the blood and organs, leading to complications such as pain crises, anemia, and organ damage. Skin changes like depigmentation are not characteristic of this condition and may indicate other underlying issues.
Choice C rationale
Enlarged mandibular growth is not a common finding in sickle cell anemia. While children with sickle cell anemia may experience growth delays and skeletal abnormalities due to chronic anemia and bone marrow hyperactivity, mandibular enlargement is not a typical feature. Skeletal changes in sickle cell anemia are more likely to involve long bones and vertebrae.
Choice D rationale
Increased growth of long bones is not a characteristic finding in sickle cell anemia. In fact, children with sickle cell anemia may experience growth delays and shorter stature due to chronic anemia and the body’s increased demand for red blood cell production. The condition can lead to skeletal abnormalities, but these typically involve bone infarctions and deformities rather than increased growth.
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View Related questions
Correct Answer is A
Explanation
Choice A rationale
Rheumatic fever is often preceded by a streptococcal infection, such as strep throat. A sibling with a sore throat 3 weeks ago could have had a strep infection, which is a significant risk factor for developing rheumatic fever.
Choice B rationale
Chickenpox is caused by the varicella-zoster virus and is not related to rheumatic fever, which is a complication of streptococcal infections.
Choice C rationale
Gastritis is an inflammation of the stomach lining and is not associated with rheumatic fever.
Choice D rationale
Fifth disease is caused by parvovirus B19 and is not related to rheumatic fever.
Correct Answer is C
Explanation
Choice A rationale
The conjunctivae, the mucous membranes that cover the front of the eye and line the inside of the eyelids, can show signs of cyanosis. However, they are not the most reliable indicator of central cyanosis. Central cyanosis is best observed in areas with a rich blood supply and thin skin, where the bluish discoloration due to low oxygen levels in the blood is more apparent.
Choice B rationale
The soles of the feet are not a reliable indicator of central cyanosis. Peripheral cyanosis, which affects the extremities, can occur due to poor circulation or cold temperatures and does not necessarily indicate central cyanosis. Central cyanosis is more accurately assessed in areas with a high concentration of blood vessels and thin skin.
Choice C rationale
The oral mucosa, including the lips and tongue, is the most reliable indicator of central cyanosis. This area has a rich blood supply and thin skin, making it easier to observe the bluish discoloration caused by low oxygen levels in the blood. Central cyanosis is a sign of significant hypoxemia and requires prompt medical attention.
Choice D rationale
The ear lobes are not the most reliable indicator of central cyanosis. While they can show signs of cyanosis, they are not as accurate as the oral mucosa. The ear lobes may be affected by peripheral cyanosis, which can occur due to factors like cold temperatures or poor circulation, rather than central cyanosis.