Family Nurse Practitioner Exam

What is the most appropriate intervention for a child with sickle cell anemia experiencing priapism?

1. Insert a Foley catheter and measure intake and output

2. Insert a Foley catheter to obtain a urinalysis

3. Recommend an increase in the child's fluid intake

4. Recommend immediate referral to the ER

The correct answer is: Recommend immediate referral to the ER

In cases of priapism, especially in children with sickle cell anemia, the condition can lead to serious complications, such as ischemia and permanent damage to the erectile tissues if not treated promptly. Priapism is often a painful and prolonged erection that can occur due to the sickling of blood cells, obstructing blood flow. Immediate referral to the emergency room is critical, as it allows for comprehensive evaluation and urgent interventions that may include hydration, pain management, and possibly procedures to relieve the priapism. Treatments in the emergency setting can include aspiration of blood from the penis or medicinal therapies to reduce the spasm of blood vessels, preventing further complications. While hydration and increasing fluid intake can be beneficial for children with sickle cell anemia overall to prevent vaso-occlusive crises, in the acute setting of priapism, these actions are not sufficient to address the immediate needs and risks associated with this condition. Additionally, inserting a Foley catheter is not an appropriate intervention in this situation and does not address the underlying problem of priapism while potentially complicating the situation further.