A nurse is caring for a child with newly diagnosed acute lymphoblastic leukemia. What clinical findings does the nurse anticipate when assessing the child? Select all that apply.
Fatigue
Generalized edema
Pallor
Jaundice
Multiple bruises
Correct Answer : A,C,E
A. Fatigue: Children with ALL often experience fatigue and weakness due to decreased red blood cell and platelet production as a result of bone marrow involvement by leukemia cells.
C. Pallor: Pallor, or paleness, is a common finding in children with ALL because of anemia (reduced red blood cell count).
E. Multiple bruises: Children with ALL may have an increased tendency to bruise and bleed due to low platelet counts, making them susceptible to easy bruising and petechiae.
The other options, B (Generalized edema) and D (Jaundice), are not typical clinical findings associated with ALL. Generalized edema is not a common symptom, and jaundice (yellowing of the skin and eyes) is more commonly associated with liver conditions, not leukemia.
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Related Questions
Correct Answer is C
Explanation
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.
Correct Answer is C
Explanation
A. Dress the child in woolen clothes during cold months: Wool can be irritating to the skin and may worsen eczema symptoms. Cotton or soft fabrics are typically better choices.
B. Launder the child's clothing with fabric softener: Fabric softeners often contain chemicals that can irritate the skin. It's best to use fragrance-free and hypoallergenic detergents and skip fabric softeners.
C. Apply a topical corticosteroid ointment to the affected area.
When teaching a parent of a preschooler with eczema, it's essential to provide guidance on appropriate treatments. Applying a topical corticosteroid ointment is an effective approach for managing eczema symptoms. These medications can help reduce inflammation and itching, which are common in eczema. However, it's crucial for the parent to use them as directed by a healthcare provider and not excessively.
D. Give the child a bubble bath every day: Frequent bathing, especially with bubble baths, can dry out the skin and worsen eczema. It's usually better to limit baths and use gentle, fragrance-free cleansers.
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