Practice Question
A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.
Answer Choices:
Correct Answer:
Monitor oxygen saturation continuously.
Rationale:
🩸 A. Monitor oxygen saturation continuously
🩸 Hypoxia can worsen sickling of red blood cells, increasing the risk of further vaso-occlusion, organ ischemia, and pain.
🩸 Pulse oximetry ensures that the nurse can detect and respond to oxygen desaturation quickly.
🩸 While the current O₂ sat is 95%, it is critical to monitor continuously during crises, as the client is in pain, febrile, and tachypneic.
🩸 Ensuring adequate oxygen delivery supports tissue perfusion and reduces the risk of complications such as acute chest syndrome.
💊 C. Give oral hydroxyurea
💊 Hydroxyurea is a disease-modifying medication for sickle cell disease that increases fetal hemoglobin (HbF) production, which reduces the occurrence and severity of vaso-occlusive episodes.
💊 It decreases the number of sickled cells, thereby reducing pain crises, hospitalizations, and transfusion needs.
💊 Although it’s not an acute pain reliever, continuing or initiating hydroxyurea as prescribed supports long-term crisis reduction and bone marrow suppression management.
💊 This should be administered unless contraindicated, and dosing is based on weight and blood count monitoring.
💉 E. Instruct the parent to ensure the pneumococcal vaccine is current
💉 Clients with sickle cell disease are functionally asplenic due to repeated splenic infarcts, placing them at high risk for pneumococcal infections.
💉 Vaccination against Streptococcus pneumoniae is essential for infection prevention, which can trigger or worsen crises.
💉 The nurse should reinforce that routine and booster vaccinations (PCV13, PPSV23) must be up to date, especially if the child is febrile or recovering.
💉 Infection prevention is a cornerstone of long-term management in pediatric sickle cell care.
🛏️ F. Place the client on strict bed rest
🛏️ Bed rest reduces oxygen demand, minimizes joint strain, and helps control pain and inflammation during vaso-occlusive crises.
🛏️ This does not mean complete immobility, but during the acute pain phase, rest is essential to reduce metabolic stress and prevent further sickling.
🛏️ Once the crisis subsides, gentle mobilization can be introduced to prevent thromboembolic events and deconditioning. 🍃 G. Administer folic acid as prescribed
🍃 Folic acid supports red blood cell production, which is vital because patients with sickle cell disease are constantly undergoing hemolysis.
🍃 This adolescent has a low hemoglobin of 6 g/dL, which reflects chronic anemia common in sickle cell.
🍃 Supplementation helps the bone marrow produce new RBCs, supporting oxygen transport and recovery.
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This question is from RN ATI Pediatric Nursing~2023 B which contains 69 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Pediatrics
- Answer Choices: 7