In anticipation of the admission of a child with hereditary ...

[saliriagwu]

In anticipation of the admission of a child with hereditary spherocytosis (HS) who is experiencing an aplastic crisis, what action should the nurse plan?
 
  a. Secure an isolation room.
  b. Prepare for a transfusion of packed red blood cells.
  c. Anticipate preoperative preparation for a splenectomy.
  d. Gather equipment and medication for treatment of shock.

Question 2

A 5-year-old child is admitted to the hospital in a sickle cell crisis. The child has been alert and oriented but in severe pain. The nurse notes that the child is complaining of a headache and is having unilateral hemiplegia.
 
  What action should the nurse implement?
  a. Notify the health care provider.
  b. Place the child on bed rest.
  c. Administer a dose of hydrocodone (Vicodin).
  d. Start O2 per the hospital's protocol.

[kjohnson]

Answer to Question 1

ANS: B
In hereditary spherocytosis, aplastic crisis results in a sudden cessation of RBC production by the bone marrow. Hemoglobin and hematocrit values drop rapidly, which results in severe anemia. Transfusion support may be needed, and close monitoring of the child's cardiovascular status is necessary. The nurse should prepare for a transfusion of packed red blood cells initially. An isolation room is not needed, splenectomy would not be done at this time, and the child will not be in shock.

Answer to Question 2

ANS: A
Any number of neurologic symptoms can indicate a minor cerebral insult, such as headache, aphasia, weakness, convulsions, visual disturbances, or unilateral hemiplegia. Loss of vision is usually the result of progressive retinopathy and retinal detachment. The nurse should notify the health care provider.

[saliriagwu]

TYSM

[xiaomengxian]

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