Question

A nurse is collecting data from a 6-month-old child who is experiencing a sickle cell crisis. Which of the following areas should the nurse observe when monitoring for manifestations of splenic sequestration?

A. The child's respiratory status, including rate, depth, and effort of breathing.

B. The child's cardiovascular status, including heart rate, blood pressure, and capillary refill time.

C. The child's abdominal status, including palpation for splenomegaly and guarding.

D. The child's neurological status, including level of consciousness, motor function, and cranial nerve function.

Answer 1

The nurse should observe the child's abdominal status, including palpation for splenomegaly and guarding, when monitoring for manifestations of splenic sequestration.

Step-by-step explanation:

When monitoring for manifestations of splenic sequestration in a 6-month-old child experiencing a sickle cell crisis, the nurse should observe the child's abdominal status, including palpation for splenomegaly and guarding (option C). In splenic sequestration, sickled red blood cells become trapped in the spleen, causing it to enlarge rapidly. This can lead to severe anemia and potentially life-threatening complications if not detected and treated promptly.