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. An intravenous line is needed in a school-age child. What medication is an appropriate analgesic for use with this patient?

A. TAC (tetracaine, epinephrine [Adrenalin], cocaine) 15 minutes before the procedure.
B. A transdermal fentanyl (Duragesic) patch at the site of venipuncture.
C. EMLA (eutectic mixture of local anesthetics) immediately before the procedure.
D. LMX (4% liposomal lidocaine cream) 30 minutes before the procedure.

Correct answer: D

Rationale: LMX is an effective analgesic agent when applied to the skin 30 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after application to nonintact skin, making it more suitable for wound suturing. Transdermal fentanyl patches are designed for continuous pain control, not rapid pain control needed for a procedure like venipuncture. EMLA, for maximum effectiveness, must be applied approximately 60 minutes before the procedure, making it less suitable for immediate pain relief required for intravenous line placement.

3. A foster parent is talking to the nurse about the health care needs for the child who has been placed in the parent's care. Which statement best describes the health care needs of foster children?

A. Foster children always come from abusive households and are emotionally fragile.
B. Foster children tend to have a higher than normal incidence of acute and chronic health problems.
C. Foster children are usually born prematurely and require technologically advanced health care.
D. Foster children will not stay in the home for an extended period, so health care needs are not as important as emotional fulfillment.

Correct answer: B

Rationale: Foster children often have higher rates of acute and chronic health problems due to a variety of factors, including previous neglect, trauma, and inconsistent healthcare access.

4. Rectal temperatures are indicated in which situation?

A. In the newborn period
B. Whenever accuracy is essential
C. Rectal temperatures are never indicated
D. When rapid temperature changes are occurring

Correct answer: B

Rationale: Rectal temperatures provide the most accurate measurement of core body temperature and are therefore indicated when accuracy is essential.

5. What are classified as hydrocarbon poisons?

A. All below
B. Gasoline
C. Turpentine
D. Lighter fluid

Correct answer: A

Rationale: Hydrocarbon poisons include substances like gasoline, turpentine, and lighter fluid, which are typically liquids derived from petroleum. Bleach is a corrosive substance, not a hydrocarbon.