A nurse in a provider's office is caring for a child who has a history of asthma. Which of the following findings should the nurse report to the provider?

Choice A reason: Loss of appetite is not an urgent finding, as it may be caused by various factors, such as nausea, pain, or stress. The nurse should monitor the child's fluid and calorie intake and encourage oral hydration and nutrition. However, loss of appetite does not require immediate reporting to the health care provider.

Choice B reason: Platelet count is not an urgent finding, as it is not given in the text. The nurse should check the child's laboratory results and compare them with the normal ranges for preschoolers. A normal platelet count for children is 150,000 to 450,000 per microliter of blood¹. A low platelet count (thrombocytopenia) may indicate bleeding disorders, infections, or bone marrow problems. A high platelet count (thrombocytosis) may indicate inflammation, infection, or cancer. The nurse should report any abnormal platelet count to the health care provider, but it is not an immediate concern.

Choice C reason: Developmental regression is an urgent finding, as it may indicate a serious neurological problem, such as a brain tumor, infection, or injury. Developmental regression is the loss of previously acquired skills or milestones, such as language, motor, or social skills. The nurse should assess the child's developmental level and report any signs of regression to the health care provider as soon as possible.

Choice D reason: Absolute neutrophil count is an urgent finding, as it may indicate a severe infection or a compromised immune system. Neutrophils are a type of white blood cell that fight bacterial infections. The absolute neutrophil count is the number of neutrophils in a microliter of blood. A normal absolute neutrophil count for children is 1,500 to 8,000 per microliter of blood². A low absolute neutrophil count (neutropenia) may increase the risk of infection and sepsis. A high absolute neutrophil count (neutrophilia) may indicate an acute infection or inflammation. The nurse should report any abnormal absolute neutrophil count to the health care provider immediately.

Choice E reason: Hemoglobin is not an urgent finding, as it is not given in the text. The nurse should check the child's laboratory results and compare them with the normal ranges for preschoolers. Hemoglobin is a protein in red blood cells that carries oxygen. A normal hemoglobin level for children is 11.5 to 15.5 grams per deciliter of blood³. A low hemoglobin level (anemia) may indicate blood loss, iron deficiency, or bone marrow problems. A high hemoglobin level (polycythemia) may indicate dehydration, lung disease, or heart disease. The nurse should report any abnormal hemoglobin level to the health care provider, but it is not an immediate concern.

Choice A reason: This is not a correct instruction for the nurse to include in the teaching. Emphasizing the quantity, rather than the quality, of food consumed may lead to overeating, obesity, or malnutrition. The nurse should encourage the mother to offer a variety of healthy foods in appropriate portions and avoid forcing or bribing the child to eat.

Choice B reason: This is not a correct instruction for the nurse to include in the teaching. Expecting that food consumption might not decrease significantly may cause the mother to ignore the signs of poor nutrition or growth in the child. The nurse should advise the mother to monitor the child's weight, height, and development regularly and consult the provider if there are any concerns.

Choice C reason: This is a correct instruction for the nurse to include in the teaching. Adding fruit juice to the child's diet can increase the vitamin intake, especially vitamin C, which is important for immune function and wound healing. The nurse should recommend the mother to choose 100% fruit juice and limit the amount to 4 to 6 oz per day.

Choice D reason: This is not a correct instruction for the nurse to include in the teaching. Having the child remain at the table after meals to increase food intake may create a negative association with eating and cause more resistance or frustration. The nurse should suggest the mother to make mealtime a pleasant and relaxed experience and respect the child's appetite and preferences.