An 8-year-old is admitted to the hospital in sickle cell crisis, appropriate nursing care during this period… - AIIMS Bhatinda NO - 2019

AIIMS Bhatinda NO - 2019

Child Health Nursing (Pediatrics)

Medium

Appeared in: AIIMS Bhatinda NO - 2019

Explanation

The pathophysiology of sickle cell crisis involves vaso-occlusion by sickled red blood cells, leading to tissue ischemia and hypoxia.
Administering supplemental oxygen increases the oxygen saturation in the blood.
Higher oxygen levels can help prevent red blood cells from assuming the sickle shape and improve oxygen delivery to tissues that are starved of oxygen.
This intervention directly addresses the underlying hypoxia and is a key component of managing an acute crisis, especially if the patient's oxygen saturation is low.

Option B: Cold compresses cause vasoconstriction, which would worsen the vaso-occlusive crisis by further restricting blood flow and increasing pain.
Option C: Dehydration is a primary trigger for sickling and can worsen a crisis by increasing blood viscosity. Fluid restriction is dangerous.
Option D: Active exercises increase pain and oxygen demand, which can exacerbate the sickling process and tissue ischemia. Rest is essential during an acute crisis.

Clinical Relevance

Nursing practice connection: Use the key finding related to Nursing management of acute sickle cell crisis in a pediatric patient to guide bedside assessment, documentation, and the next nursing action.
The mnemonic 'HOP' (Hydration, Oxygenation, Pain control) is a vital tool for nurses to remember the priorities in managing an acute sickle cell crisis.
A critical patient safety issue is avoiding cold applications. Applying a cold pack to a painful joint in a patient with sickle cell disease can cause significant harm and intensify the crisis. Always use warmth.
What if? If the patient in crisis had an oxygen saturation of 99% on room air, oxygen administration would be less of a priority than aggressive IV hydration and pain management. Oxygen is primarily for patients who are hypoxic.

How to Approach the Question

First, identify the core clinical condition: an acute sickle cell crisis in a child.
Recall the underlying pathophysiology: sickled red blood cells block small blood vessels (vaso-occlusion), causing pain and lack of oxygen to tissues (hypoxia).
Think about the primary goals of treatment: improve oxygenation, improve hydration to decrease blood viscosity, and manage severe pain.
Evaluate each option against these goals.
Option A (Oxygen): Directly addresses hypoxia. This is a core treatment goal.
Option B (Cold compress): Causes vasoconstriction, which is the opposite of what is needed. This would worsen the problem.

Concept Tested & Keywords

Concept Tested: Nursing management of acute sickle cell crisis in a pediatric patient.
Stem keywords: 8-year-old, sickle cell crisis, nursing care
Lead-in keywords: appropriate
Clinical cues: The patient is a child, which guides age-appropriate interventions.
Clinical cues: The patient is in an acute crisis, indicating the need for emergency management.

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