A nurse is admitting a child who has leukemia and a critically low platelet count. Which of the following precautions should the nurse initiate?

Neutropenic

Droplet

Bleeding

Contact

Answer and Explanation

The Correct Answer is C

A. Neutropenic Precautions: Neutropenia refers to a low neutrophil count, a type of white blood cell responsible for fighting infections. While children with leukemia are at risk for neutropenia due to the disease and its treatment, the primary concern in this scenario is the critically low platelet count and the risk of bleeding. Neutropenic precautions focus on preventing infections.

B. Droplet Precautions: Droplet precautions are used when dealing with respiratory infections that are transmitted through respiratory droplets, such as coughing or sneezing. This is not the primary concern for a child with leukemia and a low platelet count, as the main risk is bleeding due to the low platelet count.

C. Bleeding Precautions: Leukemia, especially in a child with a critically low platelet count, puts the child at a high risk of bleeding. Platelets are essential for blood clotting, and when they are severely decreased, even minor injuries can lead to excessive bleeding. The nurse should take precautions to minimize the risk of bleeding. This includes avoiding invasive procedures, using a soft toothbrush, and ensuring that the child does not participate in activities that could result in injury.

D. Contact Precautions: Contact precautions are used to prevent the transmission of infectious diseases through direct contact. While a child with leukemia may have a weakened immune system and be at risk of infections, the primary concern in this case is the critically low platelet count and the risk of bleeding. Contact precautions are more relevant in cases of contagious diseases where physical contact could transmit the infection.

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Correct Answer is A

Explanation

A. "You can give your child acetaminophen (Tylenol) every 4-6 hours as needed for pain."

Option A is the most appropriate response because it addresses pain management, which is a common symptom in cases of tonsillitis. Acetaminophen can be used to provide relief from pain and fever, which are often associated with viral tonsillitis. However, it's important for the parent to follow the dosing instructions on the medication label and consult with their healthcare provider if they have any concerns or if the child's condition worsens.

Option B ("You will need to schedule a follow-up appointment in 2 weeks") is also not the best initial response, as it doesn't address immediate care at home for the child's comfort and pain relief.

Option C ("You will need to give your child a prescribed antibiotic for 10 days") is not the correct approach, as antibiotics do not treat viral illnesses. Viral tonsillitis is usually caused by a viral infection, and antibiotics are not effective for viral infections.

Option D ("You can place warm towels around your child's neck for comfort") can provide some comfort but is not the primary treatment for viral tonsillitis. It may help alleviate discomfort, but pain relief with acetaminophen is typically more effective.

A. Engage the child in games with other children B. Encourage the child to feed himself finger foods C. Allow the child to walk independently on the nursing unit D. Hold and cuddle the child often

Correct Answer is B

Explanation

A. Engaging the child in games with other children is important for social development, but it depends on the child's individual readiness and comfort level with social interactions. It's crucial to consider the child's temperament and developmental stage.

B. Encourage the child to feed himself finger foods.

At 18 months of age, children are typically developing their fine motor skills and independence. Encouraging self-feeding with finger foods is a developmentally appropriate activity. It promotes independence, fine motor skill development, and a positive feeding experience.

C. Allowing the child to walk independently on the nursing unit is appropriate if the child is developmentally ready and safe to do so. It promotes gross motor skill development and independence.

D. Holding and cuddling the child often is important for emotional and social development. However, the frequency and style of interaction should be individualized based on the child's preferences and needs. Some children may prefer more independence at this age.

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A nurse is admitting a child who has leukemia and a critically low platelet count. Which of the following precautions should the nurse initiate?

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