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 C
Explanation
Choice A rationale
Keeping the child flat and applying pressure to the bridge of the nose is not effective for managing a nosebleed. The child should be in an upright position to reduce blood flow to the nose and prevent swallowing blood.
Choice B rationale
Turning the child’s head to the side and pressing on the nasal ridge is not the recommended approach for managing a nosebleed. The child should be in an upright position with pressure applied to the sides of the nose.
Choice C rationale
Sitting the child upright and applying pressure to the sides of the nose is the correct action. This position helps to reduce blood flow to the nose and applying pressure helps to stop the bleeding.
Choice D rationale
Elevating the head of the bed slightly and applying pressure to the forehead is not effective for managing a nosebleed. The child should be in an upright position with pressure applied to the sides of the nose to stop the bleeding. .
Correct Answer is C
Explanation
Choice A rationale
Offering clear liquids for the first 24 hours is not necessary after a cardiac catheterization. The child can resume a normal diet as tolerated unless otherwise instructed by the healthcare provider. Clear liquids are typically recommended after procedures involving the gastrointestinal tract to prevent nausea and vomiting, but this is not the case here.
Choice B rationale
Keeping the child home for a week is not required. The child can usually return to normal activities within a day or two, depending on the healthcare provider’s instructions. Prolonged rest is not necessary unless there are complications or specific instructions from the healthcare provider.
Choice C rationale
Acetaminophen is recommended for discomfort because it is effective in managing mild to moderate pain and has a low risk of side effects. It is important to avoid medications that can increase bleeding risk, such as aspirin or ibuprofen, especially after a procedure like cardiac catheterization.
Choice D rationale
Assisting the child to take a tub bath for the first 3 days is not recommended. It is generally advised to avoid submerging the catheter insertion site in water to prevent infection. Sponge baths are usually recommended until the site has healed.