Peds 3
You are caring for a 13-year-old diagnosed with sickle cell anemia. The client asks you what they can do to help prevent sickle cell crisis. What would be an appropriate answer to this client?a) Drink at least 8 glasses of water every day.b) Avoid any sports that tire you out.c) Stay on oxygen therapy 24/7.d) Avoid any activity that makes you short of breath
Drink at least 8 glasses of water every day.CorrectExplanation:During the physical examination, observe the client's appearance, looking for evidence of dehydration, which may have triggered a sickle cell crisis. Clients are taught moderation, not avoidance of activities. Most clients with sickle cell disease are not on oxygen therapy 24/7.
The nurse is talking with the parents of a toddler who was diagnosed with hemophilia A. The nurse teaches the parents) To allow the toddler to participate in playground activities with other toddlers) The importance of administering over-the-counter preparations for a cold) How to administer factor VIII intravenously at the first sign of bleeding) That nasal packing will be necessary for any nose bleeds
How to administer factor VIII intravenously at the first sign of bleedingExplanation:Clients and families are taught to administer factor VIII intravenously. This helps to prevent bleeding episodes. Activities that minimize trauma are allowed for the toddler, and playground activities may place the toddler at risk for increased bleeding. Over-the-counter cold preparations are to be avoided, because they will interfere with platelet aggregation. Nasal packing is avoided, because when the nasal packing is removed, bleeding may occur.
A young male client is diagnosed with a mild form of hemophilia. He is experiencing bleeding in the joints with pain. In preparing the client for discharge, the nurse educates the client toa) Wear a medical identification bracelet.b) Take ibuprofen (Motrin) for joint pain.c) Undergo genetic testing and counseling.d) Take warm baths to lessen pain.
Wear a medical identification bracelet.Explanation:Clients with hemophilia should wear a medical identification bracelet about having this disease. Ibuprofen interferes with platelet aggregation and may increase the client's bleeding. A warm bath may lessen pain but increase bleeding. Genetic testing and counseling are not necessary for male clients, because females are the carriers of the genetic material for hemophilia.
The nurse on the pediatric unit is caring for a 10-year-old boy with a diagnosis of hemophilia. The nurse knows that a priority nursing diagnosis for a patient with hemophilia is what?A) HypothermiaB) DiarrheaC) Ineffective copingD) Imbalanced nutrition: Less than body requirements
Ans: CFeedback: Most patients with hemophilia are diagnosed as children. They often require assistance in coping with the condition because it is chronic, places restrictions on their lives, and is an inherited disorder that can be passed to future generations. Children with hemophilia are not at risk of hypothermia, diarrhea, or imbalanced nutrition.
Following bone marrow aspiration of a 19-year-old client, analysis reveals more than 20% immature blast cells. Platelet counts are 9000/mm³. What nursing interventions should the nurse employ for the care of this client? Select all answers that apply.A) Administer prescribed docusate (Colace) daily.B) Recommend taking ibuprofen for mild aches and pains.C) Apply pressure to venipuncture sites for 1 to 2 minutes.D) Assess for mental state changes.E) Discuss the withholding of oral contraceptives.
A, D(Administer prescribed docusate (Colace) daily.Assess for mental state changes.The client has leukemia with immature blast cells and an extremely low platelet count. The client is at increased risk for bleeding. Interventions that would address bleeding include assessing for mental status changes (because bleeding could occur in the brain) and administering stool softeners to prevent constipation (which would increase the risk of bleeding from the rectum). Oral contraceptives would be administered to induce amenorrhea. Ibuprofen would be avoided because this medication inhibits platelet function. The nurse is to apply pressure to venipuncture sites for 5 minutes.)
A nurse is preparing to discharge an adolescent with sickle cell anemia. What client need should the nurse emphasize in her discharge assessment?a) The need to have pain medication availableb) The need for an adequate support structurec) The need to maintain good hydrationd) The need to follow up with physician visits
The need for an adequate support structureExplanation:Because many psychosocial and physiological issues affect the life of an adolescent with a chronic illness, assuring the existence of a good support structure is the most essential element of care. Availability of pain medication and adequate support are both important considerations, but it's more important to emphasize the need for an adequate support structure. The need for good hydration and follow-up visits are important, but a good support structure will help the adolescent with this treatment.
Which nursing instructions help parents of a child with hemophilia provide a safe home environment for their child?a) "Establish a written emergency plan including what to do in specific situations and the names and phone numbers of emergency contacts."b) "Talk with your child about home safety and have him problem-solve hypothetical situations about his health."c) "Pad the corners of coffee tables when your child is a toddler and provide kneepads for sports when the child is older."d) "Be a role model to your child by wearing a helmet when riding a bike so your child will, too."
Correct response: "Establish a written emergency plan including what to do in specific situations and the names and phone numbers of emergency contacts."Explanation:Establishing a written emergency plan that includes what to do in specific situations helps the family provide safety measures for their child with hemophilia. Padding corners of furniture and using kneepads don't help provide a safe home environment for children of all ages. Telling the parents to be a role model by wearing a bike helmet is only applicable to children who are old enough to emulate their parent's behaviors. Having the child problem-solve hypothetical health situations doesn't help provide a safe environment; it addresses problem solving
