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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.

Want to practice more questions like this?

This question is from RN ATI Pediatric Nursing~2023 Exam III which contains 54 questions.

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Answer Choices:

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From Exam
RN ATI Pediatric Nursing~2023 Exam III

54 Questions

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Question Details
  • Category: RN Nursing Exam(s)
  • Subcategory: ATI Exam(s)
  • Domain: RN ATI Pediatrics
  • Answer Choices: 8
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