Practice Question
A nurse is caring for an adolescent who is admitted with a Vaso-occlusive crisis.
Answer Choices:
Correct Answer:
Instruct the parent to ensure the pneumococcal vaccine is current.
Rationale:
✅ A. Instruct the parent to ensure the pneumococcal vaccine is current
💉 Adolescents with sickle cell disease (SCD) are at higher risk for invasive pneumococcal infections due to functional asplenia.
💉 Ensuring the pneumococcal vaccine (PCV13 and PPSV23) is current is a key preventive strategy to avoid sepsis, meningitis, and pneumonia.
💉 The nurse should confirm immunization history and educate the parent on the importance of timely vaccinations as part of long-term disease management.
💉 This aligns with CDC and WHO guidelines for preventive care in children with SCD.
✅ B. Administer folic acid as prescribed
🩺 Folic acid supports the production of new red blood cells, which is crucial in sickle cell patients who experience chronic hemolysis.
🩺 Supplementation helps prevent megaloblastic anemia and supports marrow function during crises.
🩺 It's often a routine part of outpatient and inpatient therapy for patients with SCD.
🩺 The goal is to sustain hemoglobin levels and avoid complications due to ineffective erythropoiesis.
✅ C. Monitor oxygen saturation continuously
🌬️ During a vaso-occlusive crisis, sickled red blood cells can obstruct capillaries, impairing oxygen delivery to tissues.
🌬️ Continuous pulse oximetry helps detect early signs of hypoxia, even before symptoms worsen.
🌬️ Maintaining oxygenation above 95% is vital to prevent worsening of sickling and organ ischemia.
🌬️ Early detection allows for timely intervention, including oxygen therapy or escalation of care.
✅ H. Give oral hydroxyurea
💊 Hydroxyurea increases the production of fetal hemoglobin (HbF), which reduces the polymerization of sickled hemoglobin (HbS).
💊 It helps prevent vaso-occlusive episodes, acute chest syndrome, and the need for frequent transfusions.
💊 While primarily used as preventive outpatient therapy, if the client takes it at home, it should be continued unless contraindicated.
💊 It has been shown to reduce hospitalization rates and pain crises in SCD patients.
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This question is from RN ATI Pediatric Nursing~2023 Exam III which contains 54 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Pediatrics
- Answer Choices: 8