A child with sickle cell anemia is experiencing a vaso-occlusive crisis. Which of the following actions should the nurse take?

Correct Answer: D

Rationale: During a vaso-occlusive crisis in sickle cell anemia, maintaining bed rest is crucial to reduce oxygen consumption and alleviate pain. Movement can worsen the crisis by increasing sickling of red blood cells, leading to further tissue damage and pain. Bed rest helps to improve blood flow, reduce pain, and promote healing.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Monitor the child's weight daily. Osteomyelitis is a serious infection of the bone, and monitoring the child's weight daily is crucial in assessing their nutritional status and overall health. Weight changes can indicate disease progression or response to treatment, so close monitoring is essential. Administering aspirin for pain (option A) is contraindicated in children with viral infections like osteomyelitis due to the risk of Reye's syndrome. Applying ice to the affected area (option B) is not appropriate as it can worsen the infection by vasoconstriction and reducing blood flow to the area. Limiting the child's activity (option D) may be necessary in some cases to prevent further complications, but it is not the priority in this situation. From an educational standpoint, understanding the importance of monitoring a child's weight in conditions like osteomyelitis helps nurses provide holistic care. It emphasizes the significance of ongoing assessment and the role of nursing interventions in managing pediatric patients with complex health needs.

Correct Answer: A

Rationale: In infants with heart failure, one of the key manifestations is weight gain due to fluid retention. The heart's inability to pump effectively can lead to fluid buildup in the body, causing weight gain. Bounding pulses, hyperactivity, and increased urine output are not typically associated with heart failure in infants.

Correct Answer: B

Rationale: The correct answer is B: 'Avoid administering NSAIDs.' Hemophilia is a condition where blood does not clot properly. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can increase the risk of bleeding in individuals with hemophilia. Therefore, it is crucial for the parent to avoid giving their child NSAIDs for pain management to prevent exacerbating bleeding tendencies.

Correct Answer: B

Rationale: In caring for a 2-year-old child diagnosed with Wilms' tumor, the physical assessment technique that should be omitted is palpating the abdomen (Option B). This is because Wilms' tumor is a type of kidney cancer that primarily affects the kidneys, and palpating the abdomen could potentially disrupt the tumor or cause discomfort to the child due to the proximity of the tumor to the abdominal area. Performing range-of-motion exercises on lower extremities (Option A) is important for maintaining muscle tone and preventing contractures in pediatric patients. Assessing for bowel sounds (Option C) is essential to monitor gastrointestinal function, which can be affected by various conditions including cancer. Percussing ankle and knee reflexes (Option D) is a neurological assessment technique that helps evaluate the integrity of the nervous system in pediatric patients. Educationally, understanding the rationale behind omitting abdominal palpation in a child with Wilms' tumor emphasizes the importance of tailoring physical assessments to specific conditions to prevent harm or discomfort to the patient. It highlights the significance of considering the underlying pathology when conducting assessments in pediatric patients to provide safe and effective care.