A 2-year-old child who has sickle cell anemia (SCA) comes to the clinic with a cough and a fever of 101.5°F. The child currently takes penicillin V prophylaxis 125 mg orally twice daily. What will the primary care pediatric nurse practitioner do?

Choice A reason: IV fluids and antibiotics may be part of hospital management, but administering them in clinic without further evaluation is insufficient for a child with SCA and fever, who is at high risk for sepsis. Choice B reason: Increasing the prophylactic dose is not appropriate for acute febrile illness. The child needs urgent evaluation for possible infection, not adjustment of prophylaxis. Choice C reason: Children with SCA and fever are at high risk for life-threatening infections due to functional asplenia. Hospital admission for evaluation and empiric IV antibiotics is the standard of care to rule out sepsis and acute chest syndrome. Choice D reason: A chest radiograph may be ordered, but it does not replace the need for hospital admission and full sepsis workup. It is part of the diagnostic process, not the primary management decision.