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A child with sickle cell anemia (SCA) develops severe chest and back pain, fever, a cough, and dyspnea. What should be the first action by the nurse?
- A. Administer 100% oxygen to relieve hypoxia.
- B. Notify the practitioner because chest syndrome is suspected.
- C. Infuse intravenous antibiotics as soon as cultures are obtained.
- D. Give ordered pain medication to relieve symptoms of pain episode.
Correct Answer: B
Rationale: Symptoms suggest acute chest syndrome, a medical emergency in SCA, requiring immediate practitioner notification. Oxygen may be needed but doesn?t reverse sickling, antibiotics follow evaluation, and pain management is secondary to addressing the emergency.
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In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxia-ischemia cycle. What information should the nurse share with parents in a teaching plan?
- A. Encourage drinking.
- B. Keep accurate records of output.
- C. Check for moist mucous membranes.
- D. Monitor the concentration of the childs urine.
Correct Answer: C
Rationale: Checking for moist mucous membranes assesses hydration in SCA, where impaired kidney function prevents urine concentration. General encouragement to drink is vague, output records don?t reflect fluid needs, and urine concentration is unreliable due to kidney dysfunction.
A child with severe anemia requires a unit of red blood cells (RBCs). The nurse explains to the child that the transfusion is necessary for which reason?
- A. Allow her parents to come visit her.
- B. Fight the infection that she now has.
- C. Increase her energy so she will not be so tired.
- D. Help her body stop bleeding by forming a clot (scab).
Correct Answer: C
Rationale: RBC transfusion increases oxygen-carrying capacity, reducing tissue hypoxia and fatigue, and preventing cardiac decompensation. It doesn?t affect visitation, isn?t for infection, and clotting is managed by platelets, not RBCs.
The parents of a child with sickle cell anemia (SCA) are concerned about subsequent children having the disease. What statement most accurately reflects inheritance of SCA?
- A. SCA is not inherited.
- B. All siblings will have SCA.
- C. Each sibling has a 25% chance of having SCA.
- D. There is a 50% chance of siblings having SCA.
Correct Answer: C
Rationale: SCA is an autosomal recessive disorder, so each sibling has a 25% chance of inheriting SCA, 25% chance of being unaffected, and 50% chance of having the trait. SCA is inherited, not all siblings will have it, and 50% applies to the trait, not the disease.
What physiologic defect is responsible for causing anemia?
- A. Increased blood viscosity
- B. Depressed hematopoietic system
- C. Presence of abnormal hemoglobin
- D. Decreased oxygen-carrying capacity of blood
Correct Answer: D
Rationale: Anemia is defined by reduced RBCs or hemoglobin, leading to decreased oxygen-carrying capacity. Increased viscosity occurs with too many cells, a depressed hematopoietic system or abnormal hemoglobin may contribute, but the core defect is reduced oxygen delivery.
For children who do not have a matched sibling bone marrow donor, the therapeutic management of aplastic anemia includes what intervention?
- A. Antibiotics
- B. Antiretroviral drugs
- C. Iron supplementation
- D. Immunosuppressive therapy
Correct Answer: D
Rationale: Immunosuppressive therapy (e.g., antilymphocyte globulin, cyclosporine) treats aplastic anemia, likely an autoimmune condition, improving prognosis. Antibiotics treat infections, not the condition; antiretrovirals and iron are irrelevant to aplastic anemia management.