A nurse is contributing to the plan of care for an adolescent client who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following interventions should the nurse include in the plan?
A.
Decrease daily oral fluid intake.
B.
Maintain bed rest to prevent hypoxemia.
C.
Apply cold compresses to painful joints.
D.
Administer meperidine to eliminate a fever.
For an adolescent client experiencing a vaso-occlusive crisis due to sickle cell anemia, the nurse should include the following intervention in the plan of care:
B. Maintain bed rest to prevent hypoxemia.
Explanation:
Maintain bed rest to prevent hypoxemia: During a vaso-occlusive crisis, maintaining bed rest helps to reduce energy expenditure and minimize stress on the body, which can help prevent further complications such as hypoxemia (low oxygen levels in the blood). This helps in managing pain and reduces the risk of complications.
Why the other options are not appropriate:
Decrease daily oral fluid intake (A): Increasing, not decreasing, fluid intake is crucial in managing sickle cell anemia. Adequate hydration helps to prevent the sickling of red blood cells and reduces the risk of vaso-occlusive crises.
Apply cold compresses to painful joints (C): Cold compresses can constrict blood vessels and potentially worsen the pain. Warm compresses are generally preferred as they help in increasing blood flow and alleviating pain in sickle cell crises.
Administer meperidine to eliminate a fever (D): Meperidine (Demerol) is generally not recommended for pain management in sickle cell crisis due to its potential side effects and risk of seizures. Additionally, fever should be evaluated and treated according to its cause. Pain management typically involves other opioids like morphine.
Therefore, maintaining bed rest is a correct and appropriate intervention for managing a vaso-occlusive crisis in sickle cell anemia.