Author Question: A school-age child is admitted in vasoocclusive sickle cell crisis. The child's care should include: ... (Read 93 times)

stevenposner · **on:** Jun 28, 2018

A school-age child is admitted in vasoocclusive sickle cell crisis. The child's care should include:

a. correction of acidosis.
b. adequate hydration and pain management.
c. pain management and administration of heparin.
d. adequate oxygenation and replacement of factor VIII.

Question 2

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. Which is appropriate for the nurse to explain about narcotic analgesics?

a. Are often ordered but not usually needed
b. Rarely cause addiction because they are medically indicated
c. Are given as a last resort because of the threat of addiction
d. Are used only if other measures, such as ice packs, are ineffective

1_Step_At_ATime · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: B
The management of crises includes adequate hydration, minimization of energy expenditures, pain management, electrolyte replacement, and blood component therapy if indicated. Hydration and pain control are two of the major goals of therapy. The acidosis will be corrected as the crisis is treated. Heparin and factor VIII is not indicated in the treatment of vasoocclusive sickle cell crisis. Oxygen may prevent further sickling, but it is not effective in reversing sickling because it cannot reach the clogged blood vessels.

Answer to Question 2

ANS: B
The pain of sickle cell anemia is best treated by a multidisciplinary approach. Mild to moderate pain can be controlled by ibuprofen and acetaminophen. When narcotics are indicated, they are titrated to effect and are given around the clock. Patient-controlled analgesia reinforces the patient's role and responsibility in managing the pain and provides flexibility in dealing with pain. Few, if any, patients who receive opioids for severe pain become behaviorally addicted to the drug. Narcotics are often used because of the severe nature of the pain of vasoocclusive crisis. Ice is contraindicated because of its vasoconstrictive effects.