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A nurse is assisting with the care of a 7-year-old child.

Exhibits
The nurse is reviewing the data collection findings and diagnostic results. For each data collection finding, click to specify if the finding is consistent with leukemia, sickle cell anemia, or hemophilia. Each finding may support more than 1 disease process.

A.

Reported pain

B.

Bleeding

C.

Temperature

D.

Bruising

E.

WBC count

Answer and Explanation

The Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,C"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"A"}}

Reported pain

  • Leukemia: Possible, as bone pain can occur due to marrow involvement.
  • Sickle Cell Anemia: Yes, common due to vaso-occlusive crises.
  • Hemophilia: No, hemophilia typically causes bleeding rather than pain from blood cell abnormalities.

Bleeding

  • Leukemia: Yes, due to thrombocytopenia.
  • Sickle Cell Anemia: No, bleeding is not typical in sickle cell crises.
  • Hemophilia: Yes, hemophilia is a bleeding disorder due to a clotting factor deficiency.

Temperature

  • Leukemia: Yes, fever can indicate infection due to immunosuppression.
  • Sickle Cell Anemia: Yes, fever can be a sign of infection during crises.
  • Hemophilia: No, hemophilia does not cause fever unless there is an infection.

Bruising

  • Leukemia: Yes, thrombocytopenia can lead to easy bruising.
  • Sickle Cell Anemia: No, bruising is not typical in sickle cell crises.
  • Hemophilia: Yes, due to a clotting factor deficiency, easy bruising is common.

WBC count

  • Leukemia: Yes, often elevated due to immature or abnormal white cells.
  • Sickle Cell Anemia: No, WBC count is usually normal unless there is an infection.
  • Hemophilia: No, WBC count is typically normal in hemophilia.


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Related Questions

Correct Answer is D

Explanation

A. Have the child eat a high-protein diet. There is no specific requirement for a high-protein diet to manage sickle cell disease. Hydration is more critical in crisis prevention.

B. Monitor the child's temperature twice per day. While monitoring for infection is essential, this is not the most important discharge instruction to prevent crises.

C. Restrict outdoor play activity. While strenuous exercise should be avoided, activity restriction is unnecessary as long as the child stays hydrated and avoids extreme conditions.

D. Encourage the child to increase his fluid intake. Increased fluid intake helps prevent sickling by reducing blood viscosity, which is essential in preventing future crises.

Correct Answer is B

Explanation

A. WBCs: White blood cell counts may vary in multiple myeloma, but they are not typically increased; in fact, WBC counts can be low due to bone marrow crowding.

B. Calcium: Multiple myeloma often causes hypercalcemia because of increased bone breakdown, leading to the release of calcium into the bloodstream.

C. Absolute neutrophil count: The absolute neutrophil count may actually decrease as a result of bone marrow dysfunction, not increase.

D. Platelets: Platelet counts are often decreased in multiple myeloma due to bone marrow involvement, not increased.

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