Which should the nurse teach about prevention of sickle cell crises to parents of a preschool child with sickle cell disease? (Select all that apply.)
a. Limit fluids at bedtime.
b. Notify the health care provider if a fever of 38.5° C (101.3° F) or greater occurs.
c. Give penicillin as prescribed.
d. Use ice packs to decrease the discomfort of vasoocclusive pain in the legs.
e. Notify the health care provider if your child begins to develop symptoms of a cold.
ANS: B, C, E
The most important issues to teach the family of a child with sickle cell anemia are to (1) seek early intervention for problems, such as a fever of 38.5° C (101.3° F) or greater; (2) give penicillin as ordered; (3) recognize signs and symptoms of splenic sequestration, as well as respiratory problems that can lead to hypoxia; and (4) treat the child normally. The nurse emphasizes the importance of adequate hydration to prevent sickling and to delay the adhesion–stasis–thrombosis–ischemia cycle. It is not sufficient to advise parents to "force fluids" or "encourage drinking." They need specific instructions on how many daily glasses or bottles of fluid are required. Many foods are also a source of fluid, particularly soups, flavored ice pops, ice cream, sherbet, gelatin, and puddings. Increased fluids combined with impaired kidney function result in the problem of enuresis. Parents who are unaware of this fact frequently use the usual measures to discourage bedwetting, such as limiting fluids at night. Enuresis is treated as a complication of the disease, such as joint pain or some other symptom, to alleviate parental pressure on the child. Ice should not be used during a vasoocclusive pain crisis because it vasoconstricts and impairs circulation even more.
You might also like to view...
The nurse refers the client to a website on smoking cessation after evaluating its contents. Which factor increases the probability that the website is appropriate for the client?
1. The site is written in technical language and has comprehensive chemical diagrams for credibility. 2. The site has a current revision date and a URAC accreditation seal that the site meets quality standards. 3. The site is sponsored by a pharmaceutical company that manufactures a smoking cessation medication. 4. The site has a list of broadly generalized indications for smoking cessation.
A distraught young father has brought his 3-year-old daughter to the clinic. She is ill and showing symptoms of pneumonia. As you take the history, the father tells you his wife was recently killed in a traffic accident
"How will I ever raise my daughter right? A girl needs her mother!" A truth about parenting that the nurse can share with the father is: A) The child will do better with both a mother and a father. B) Parenting is stressful and parents of either gender need "adult" time for themselves. C) The child will receive adequate female role modeling at day care; the father need not be concerned. D) All of the above.
In human beings, the physiologic response to a stressor includes the:
A) sympathetic nervous system slowing the heart rate. B) hypothalamus secreting adrenocorticotropic hormone. C) hypothalamus secreting thyroid-stimulating hormone. D) epinephrine increasing the blood-glucose level.
Pain medications that must travel through the bloodstream to affect cells or tissues in other parts of the body are an example of drugs given for their ________ effects.
Fill in the blank(s) with the appropriate word(s).