Nurse Christine is planning a client education program for sickle cell disease (SCD) in children; which of the following interventions would be included in the care plan?
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Solution
Health teaching to help reduce sickling crises
Option A: Prevention is one of the principal goals of therapeutic management because there is no cure for sickle cell disease. Consequently, health education to help lessen sickling crises is key.
Option B: Opioids usually are required for pain control.
Option C: Anticoagulants do not prevent sickling.
Option D: Fluids are encouraged to increase the fluid volume and prevent sickling.
In children diagnosed with sickle cell disease (SCD), tissue damage results from which of the following?
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Solution
Local tissue damage with ischemia and necrosis due to obstructed circulation
Option D: Characteristic sickle cells tend to clump, which results in weak and inadequate blood flow to tissue, local tissue damage, and eventual ischemia and necrosis.
Option A: Air hunger and respiratory alkalosis are not present.
Option B: The CNS effects result from ischemia
Option C: In sickle cell anemia, damage is not due to an inflammation response.
Which of the following is TRUE about sickle cell disease (SCD)? Select all that apply.
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Solution
Answer: A, B, C, D, and E
Options A, B, C, D, and E: Sickle cell anemia (SCD) is an inherited disorder of the hemoglobin in blood. It requires the inheritance of two sickle cell genes. Sickle cell trait, which is the inheritance of one sickle gene, almost never causes problems. Virtually all of the major symptoms of sickle cell anemia are the direct result of the abnormally shaped sickled red blood cells blocking the flow of blood. The contemporary treatment of sickle cell anemia is focused primarily toward managing the individual features of the illness as they occur.
Sickle cell disease (SCD) primarily affects:
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Solution
both African descent and Hispanics of Caribbean ancestry and Middle-Eastern and Indian descent.
Option D: Sickle cell disease primarily affects children of African descent and Hispanics of Caribbean ancestry. It also occurs in children of Middle-Eastern and Indian descent.
Nurse Katriz is planning a client education program for sickle cell disease (SCD); what topics should be included in the plan of care?
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Solution
Proper hand washing and infection avoidance
Option D: Prevention of infection is vital in the prevention of sickle cell crisis.
Option A: Strenuous activities and exercises should be withdrawn to lessen the risk of increased tissue ischemia.
Option B: Proper hydration should be encouraged to prevent crisis secondary to dehydration.
Option C: A high-iron, high-protein diet would have no impact on the disease or prevention of a crisis.
Neurovascular assessment for a fracture patient includes: Select all that apply.
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Solution
Answer: C, D, E, F, G, and H
Options C, D, E, F, G, and H: When damage occurs to a muscle or muscle group within the fascial compartment, the resulting swelling and bleeding can create an increased pressure that, if left untreated, can choke off circulation, eventually leading to localized cellular hypoxia and death. The six P’s of compartment syndrome for warning signs to watch for are Pain, Pallor, Pulselessness, Paresthesia, Paralysis, and Poikilothermia.
Match the traction methods to their corresponding descriptions:
1. Buck’s traction
2. Russell’s traction
3. Bryant’s traction
A. legs in an extended position
B. leg extended, knee flexed
C. hips flexed 90degrees, both legs
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Solution
1A, 2B, 3C
Buck’s traction is a type of skin traction with the legs in an extended position. It is used primarily for short-term immobilization, preoperatively with dislocated hips, for correcting contractures, or for bone deformities such as Legg-Calvé-Perthes disease.
Russell’s traction uses skin traction on the lower leg and a padded sling under the knee. The combination of longitudinal and perpendicular traction allows realignment of the lower extremity and immobilizes the hips and knees in a flexed position.
Bryant’s traction is skin traction with the legs flexed at a 90-degree angle at the hip.
Reggie is a teenager suffering from osteomyelitis; the nurse would expect which of the following symptoms? Select all that apply.
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Solution
Answer: A, B, D, and E
Options A, B, D, and E: The symptoms for acute and chronic osteomyelitis are very similar and include fever, irritability, fatigue, nausea, tenderness, redness (not pallor in option C), and warmth in the area of the infection, swelling around the affected bone, and lost range of motion.
Incomplete development of teeth, bones, and ligaments is the result of:
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Solution
Osteogenesis imperfecta
Option C: Osteogenesis imperfecta (OI), also known as brittle bone disease, is a group of genetic disorders that principally affect the bones. It results in bones that break quickly. The severity may be mild to severe. Other symptoms may include problems with the teeth, loose joints, a blue tinge to the whites of the eye, short height, hearing loss, and breathing problems.
Option A: Congenital hip dislocation (CHD) occurs when a child is born with an unstable hip. It is caused by abnormal formation of the hip joint during the early stages of fetal development. CHD is also known as Developmental Dysplasia of the Hip (DDH).
Option B: Duchenne muscular dystrophy (DMD) is a genetic condition marked by progressive weakening of voluntary muscles. DMD worsens more rapidly than other types of muscular dystrophy.
Option D: A bone infection, also called osteomyelitis, can result when bacteria or fungi penetrate a bone. In children, bone infections usually occur in the long bones of the arms and legs. In adults, they usually appear in the hips, spine, and feet.
You have learned that in babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. Which of the following is the most common form of DDH?
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Solution
Subluxation
Option D: DDH is a group of congenital abnormalities of the hip joints, which includes subluxation, dislocation, and preluxation. Of the types of congenital hip abnormalities, subluxation is the most common.
Options A and C: Preluxation, also known as acetabular dysplasia, is the mildest form.
Option B: Dislocation is complete displacement of the femoral head out of the acetabulum.