A school-age child is admitted in vasoocclusive sickle cell crisis. The child's care should include:
a. correction of acidosis.
b. adequate hydration and pain management.
c. pain management and administration of heparin.
d. adequate oxygenation and replacement of factor VIII.
ANS: B
The management of crises includes adequate hydration, minimization of energy expenditures, pain management, electrolyte replacement, and blood component therapy if indicated. Hydration and pain control are two of the major goals of therapy. The acidosis will be corrected as the crisis is treated. Heparin and factor VIII is not indicated in the treatment of vasoocclusive sickle cell crisis. Oxygen may prevent further sickling, but it is not effective in reversing sickling because it cannot reach the clogged blood vessels.
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