a school-age child is admitted in vaso-occlusive sickle cell crisis. the child's care should include which of the following?

Correct Answer: B

Rationale: In a vaso-occlusive sickle cell crisis, it is crucial to focus on adequate hydration and pain management. Hydration is essential to prevent further sickling of red blood cells, which can exacerbate tissue damage and pain. Pain management is a key aspect of care as vaso-occlusive crises often cause severe pain that requires prompt and effective treatment. Administering heparin is not indicated in a vaso-occlusive sickle cell crisis as it is primarily used for conditions like deep vein thrombosis. Correcting acidosis and replacing factor VIII are also not typically part of the management of a vaso-occlusive sickle cell crisis.

Correct Answer: D

Rationale: Vernix caseosa is the grayish white, cheeselike substance that normally covers a newborn's skin at the time of birth. It is a natural substance produced by the baby's skin glands while in the womb. Vernix caseosa helps protect the baby's delicate skin from the amniotic fluid in the uterus and acts as a moisturizer as well. It also has antimicrobial properties, providing a barrier against infection. After birth, healthcare providers typically wipe off or gently wash the vernix from the baby's skin during the first bath.

Correct Answer: A

Rationale: In the context of pharmacology and pediatric practice, it is essential for nurses to educate expectant parents on the contraindications for breastfeeding. Option A, Human immunodeficiency virus (HIV) in the mother, is a correct contraindication for breastfeeding due to the risk of vertical transmission of the virus to the infant through breast milk. HIV can be present in breast milk, posing a significant risk to the newborn. Options B, Mastitis, and C, Inverted nipples, are not contraindications for breastfeeding. Mastitis, which is inflammation of breast tissue, can be managed with proper treatment and does not necessarily prevent breastfeeding. Similarly, inverted nipples can often be addressed with techniques like nipple shields to facilitate breastfeeding. Option D, Maternal cancer therapy, is not a universal contraindication for breastfeeding. It depends on the specific medications used in the cancer therapy. Some medications may be safe to use during breastfeeding, while others may require temporary cessation of breastfeeding. Educationally, understanding these contraindications is crucial for nurses to provide accurate information to expectant parents, enabling them to make informed decisions about breastfeeding. It is vital to address misconceptions and provide evidence-based guidance to support successful breastfeeding practices while ensuring the safety and well-being of both the mother and the infant.

Correct Answer: A

Rationale: The most common symptom of pediculosis capitis, also known as head lice infestation, is itching of the scalp. Head lice feed on blood from the scalp, leading to irritation and allergic reactions, causing itching. Itching is often more prominent behind the ears and at the nape of the neck where head lice tend to lay their eggs (nits). While secondary symptoms such as scalp rash, vesicles, and localized inflammatory responses can occur due to scratching or allergic reactions, itching is typically the initial and predominant symptom of head lice infestation.

Correct Answer: B

Rationale: In pediatric practice, administering routine immunizations is a crucial aspect of preventive healthcare. For a 4-month-old infant who is up to date on previous immunizations, the nurse should prepare to administer the Rotavirus (RV) vaccine. This is the correct answer because the RV vaccine is recommended to be given at 2, 4, and 6 months of age to protect infants against severe diarrhea and dehydration caused by rotavirus infection. The other options are incorrect for the following reasons: A) Measles, mumps, and rubella (MMR): This vaccine is typically given between 12-15 months of age and a second dose at 4-6 years. Administering MMR at 4 months would not be in line with the recommended schedule. C) Diphtheria, tetanus, pertussis (DTaP): While this vaccine is important, the schedule for DTaP doses starts at 2 months, with subsequent doses at 4 and 6 months. Therefore, giving DTaP at 4 months alone would not be appropriate. D) Varicella: The varicella vaccine is typically given between 12-15 months and a second dose at 4-6 years. Administering varicella vaccine at 4 months would not align with the recommended schedule. Educationally, it is important to understand the timing and rationale behind each vaccine administration to ensure optimal protection for infants and children. Following the recommended immunization schedule is vital to provide immunity at the most effective times and protect against vaccine-preventable diseases.