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.

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.

A. Obtaining a throat culture and B. visualizing the epiglottis with a tongue depressor are not safe actions for the nurse to perform without appropriate medical equipment and expertise. These actions can trigger a sudden airway obstruction in a child with epiglottitis. The priority is to ensure airway patency and seek immediate medical assistance.

C. Place the child in an upright position.

Suspected epiglottitis is a medical emergency that can result in rapid airway obstruction. Placing the child in an upright position helps improve airflow by allowing the throat to open and reduces the risk of complete airway obstruction. It's important not to perform invasive procedures (such as throat culture or visualization of the epiglottis) without proper medical equipment and expertise, as these actions can lead to worsening airway obstruction.

D. Transporting the child to radiology for a throat x-ray is not appropriate in this situation, as it may delay necessary interventions to secure the airway.