Practice Question
A nurse is collecting data from a 6-month-old child who is experiencing a sickle cell crisis. Which of the following areas should the nurse observe when monitoring for manifestations of splenic sequestration? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)
Answer Choices:
Rationale:
💠 The spleen is located in the left upper quadrant (LUQ) of the abdomen, directly under the lower left rib cage, which corresponds to Hot Spot A in the image.
💠 In a 6-month-old experiencing a sickle cell crisis, the nurse must closely observe the LUQ for signs of splenic sequestration, a life-threatening complication in infants with sickle cell disease.
💠 Splenic sequestration occurs when large volumes of blood suddenly pool in the spleen, causing rapid enlargement, abdominal fullness, and decreased circulating blood volume.
💠 Clinical signs include a firm, distended spleen, pallor, irritability, and signs of hypovolemic shock, making careful LUQ observation essential.
💠 Because infants and young children are at highest risk before the spleen atrophies from repeated crises, LUQ assessment becomes a priority nursing action to detect early deterioration.
Hot Spot B
💠 Hot Spot B is located in the right upper quadrant (RUQ), corresponding to the area of the liver and gallbladder, not the spleen.
💠 Although the liver can also enlarge in some pediatric conditions, it is not the organ involved in splenic sequestration during a sickle cell crisis.
💠 Assessing the RUQ would fail to detect the sudden pooling of blood characteristic of splenic sequestration, delaying recognition of an emergency.
💠 This area would more commonly be assessed for hepatomegaly, biliary disease, or hepatitis, none of which relate to the acute complication described.
💠 Therefore, Hot Spot B does not represent the correct anatomical location for identifying splenic enlargement in sickle cell crisis.
Hot Spot C
💠 Hot Spot C represents the hypogastric/umbilical area, which contains structures such as the intestines and bladder but not the spleen.
💠 Monitoring this region would not reveal the LUQ fullness or firmness associated with splenic blood trapping during splenic sequestration.
💠 This area may be assessed for abdominal distention, bowel obstruction, or urinary issues, but these do not relate to the pathophysiology of splenic sequestration.
💠 Choosing this area would lead the nurse to miss critical early signs of life-threatening hypovolemia, delaying urgent intervention.
💠 Because this hot spot does not correspond to the anatomical location of the spleen, it is not appropriate for monitoring splenic enlargement.
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This question is from PN Pediatric Nursing Online Practice 2023 B which contains 49 questions.
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Question Details
- Category: LPN Nursing Exam(s)
- Subcategory: LPN ATI Exams
- Domain: Pediatrics
- Answer Choices: 0