A child is taking desmopressin acetate (DDAVP) for von ...

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A child is taking desmopressin acetate (DDAVP) for von Willebrand's disease. What teaching about this medication does the nurse provide?
 
  A.
  Avoid products with aspirin (salicylate) in them.
  B.
  Get a new needle for each injection.
  C.
  Monitor your child's weight and report a gain.
  D.
  Use ice packs and pressure for epistaxis.

Question 2

An acutely ill, anemic child's peripheral blood smear shows small, dense, spherical RBCs. What action by the nurse takes priority?
 
  A.
  Assess and treat the child's pain adequately.
  B.
  Discuss the option of a bone marrow transplant.
  C.
  Obtain informed consent for blood transfusions.
  D.
  Prepare the family for chelation therapy.

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Answer to Question 1

ANS: C
DDAVP can cause hypervolemia and hyponatremia. The child may show a rapid weight gain, which should be reported. Avoiding aspirin and using ice packs for nosebleeds are care measures for the disease, not the medication. DDAVP is given intranasally for this condition.

Answer to Question 2

ANS: C
The peripheral blood smear indicates spherocytosis, which, when acute, is treated with transfusions. The nurse ensures informed consent is obtained and present on the chart. Assessing and treating pain is important but does not take priority. Chelation therapy is not indicated in the question. A bone marrow transplant may or may not be considered, but is not the primary need of this child.

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