a school age child is admitted to the pediatric unit with a vaso occlusive crisis which of these should be included in the nursing plan of care

ATI RN

ATI Nursing Care of Children

1. A school-age child is admitted to the pediatric unit with a vaso-occlusive crisis. Which of these should be included in the nursing plan of care?

A. Correction of alkalosis
B. Pain management and administration of heparin
C. Adequate oxygenation and replacement of factor VIII to correct the sickling
D. Adequate hydration, oxygenation, and pain management

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia require a comprehensive approach that includes adequate hydration to reduce blood viscosity, oxygenation to prevent further sickling of red blood cells, and aggressive pain management. This approach helps improve tissue perfusion and manage pain effectively. Choices A, B, and C are incorrect. Correction of alkalosis is not a priority in vaso-occlusive crisis management. Administration of heparin is not indicated as it can increase the risk of bleeding in sickle cell patients. Factor VIII replacement is not relevant to sickle cell anemia as it is a treatment for hemophilia, not sickle cell disease.

2. What is one focus of current health care?

A. Increased provision of nursing services
B. Disease prevention
C. Symptom management
D. Identification of disease processes

Correct answer: B

Rationale: The correct answer is 'Disease prevention.' Modern healthcare places emphasis on preventing diseases to enhance overall health and well-being. While nursing services, symptom management, and disease identification are crucial components of healthcare, disease prevention plays a key role in reducing the burden of illness on individuals and communities.

3. The clinic nurse is instructing parents about caring for a toddler with ascariasis (common roundworm). Which statement made by the parents indicates a need for further teaching?

A. We will wash our hands often, especially after diaper changes
B. We know that roundworm can be transmitted from person to person
C. We will be sure to continue the nitazoxanide (Alinia) orally for 3 days
D. We will bring a stool sample to the clinic for examination in 2 weeks

Correct answer: B

Rationale: Roundworm (ascariasis) is typically transmitted through ingestion of contaminated soil, not directly from person to person. This statement indicates a misunderstanding requiring clarification.

4. The nurse is preparing to admit a 7-year-old child with Crohn disease. What clinical manifestations should the nurse expect to observe?

A. Pain is common.
B. Weight loss is severe.
C. All are correct.
D. Diarrhea is moderate to severe.

Correct answer: C

Rationale: The correct answer is C because Crohn's disease commonly presents with pain, severe weight loss, and moderate to severe diarrhea in affected individuals. Therefore, all the manifestations listed are typically observed in patients with Crohn's disease. Choice A alone is not sufficient as weight loss and diarrhea are also prominent symptoms. Choice B is incorrect as it only mentions weight loss, omitting other common manifestations. Choice D is also incorrect as it does not cover the full range of expected clinical signs in Crohn's disease.

5. What is the recommended method to assess hydration status in infants?

A. Capillary refill time
B. Skin turgor
C. Urine output
D. Mucous membranes

Correct answer: C

Rationale: The correct answer is C: Urine output. Assessing urine output is a recommended method to determine hydration status in infants. Adequate urine output indicates good hydration, while decreased urine output may suggest dehydration. Capillary refill time (Choice A) is more indicative of circulatory status rather than hydration. Skin turgor (Choice B) is a useful assessment in adults but can be less reliable in infants. Checking mucous membranes (Choice D) can provide some information on hydration, but it is not as reliable as assessing urine output in infants.