A nurse is caring for a 6-week-old infant who has hypertrophic pyloric stenosis (HPS). Which of the following clinical manifestations should the nurse expect?

A. Thrombocytopenia: Thrombocytopenia is a condition characterized by a low platelet count, and it is not a typical feature of iron-deficiency anemia.

B. Increased Total Iron-binding Capacity: In iron-deficiency anemia, the Total Iron-binding Capacity (TIBC) is typically increased as the body attempts to compensate for the low iron levels by increasing its capacity to bind and transport iron.

C. Decreased Folate Levels: While iron-deficiency anemia and folate-deficiency anemia are both forms of anemia, decreased folate levels are more characteristic of folate-deficiency anemia, which is a separate condition.

D. Microcytic Red Blood Cells.

Iron-deficiency anemia is characterized by a decrease in the body's iron stores, which in turn affects the production of hemoglobin and red blood cells. This results in the formation of microcytic (smaller than normal) red blood cells. These smaller red blood cells are a typical finding in iron-deficiency anemia.

A. Appropriate dose of aspirin and rest: Aspirin is an antiplatelet medication that can worsen bleeding in individuals with hemophilia. It should be avoided. Rest alone is not sufficient in this situation.

B. Immobilization of the leg and a dose of ibuprofen: Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding. Immobilizing the leg may help prevent further injury, but it does not address the underlying bleeding issue or provide the necessary clotting factor.

C. Heating pad and administration of factor VIII concentrate: While the administration of factor VIII concentrate is appropriate, the use of a heating pad is not advisable, as it can potentially worsen bleeding by dilating blood vessels in the area.

D. Pressure on the site and administration of the required clotting factor.

Hemophilia is a bleeding disorder in which the blood doesn't clot properly. When a hemophilic child has a significant bruise or bleeding, it is crucial to administer the specific clotting factor that they are deficient in (Factor VIII or IX) to stop the bleeding. Applying pressure to the site can also help control bleeding.

In summary, option D is the priority because it directly addresses the bleeding issue in the child with hemophilia by applying pressure to the site and administering the necessary clotting factor. This is crucial in preventing further bleeding and complications.