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,,u~v,a,uz11r11a~.eyJ1eFtAIOJE3MJ12M°TgxOOQsllJIZmVyZW5jZUIEljoiODU5NTQ5NilslkF1dGh … * JID’1:f~ll”Y-‘vt:Af\JVIJl’\._v _•w_~-;w.1~-~-~-~~~–~—–~–… ·–_……–……,..____:;; ________ ~ __ _,_, ,ashboard _ San J… + Course Point Jt 1 (Heme, 0/, Skin) Heme, CV, Skin) Child sitting on bed, appears to have been crying. Alert and answers questions appropriately; PERR.LA, sclera yellow. lung sounds clear, respirations tachypneic at 40/min. He·art rate 108/min. Peripheral pulses palpable and strong. Capillary refill less than 3 seconds in bilateral upper extremities and less than 4 seconds in bilateral lower extremities. Oral mucosa pink and dry. Abdomen soft with active bowel sounds in all four quadrants. Child reports pain in abdomen and legs as 6 on FACES pain scale. Knees and hand joints are swollen, red, and warm to touch. Skin dry with poor turgor and tenting. The caregiver reports the child has had • three hospitaHzations in the past 8 months due to sickle cell crisis. The child’s temperature is 38.3° C (100.9° F) and SpO2 is 88% on room air. Which of the following concerns should the nurse address whHe providing cHent care? (Select all that apply.) 0 Physiological: Pain 0 Physiological: Gas Exchange 0 Physiological: Thermoregulation 0 Physiological El1minat on 0 Physiological· Inflammation 0 Physiological· Metabolism 0 Safety: lnJury Preventio __ ) —–~–==-“‘—-===.;…._____;;.,…. ___ ~-~—==—-=—–l O Physiological: Gas Exchange r 1 O Physiological: Thermoregulation D Physiological: Elimination D Physiological: Inflammation D Physiological: Metabolism O Safety: Injury Prevention D Health Promotion: Ctient Education D Psychosocial: End of Life D Physiological: Perfusion j
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