A nurse is planning care for a preschooler who has leukemia. After reviewing the child's information, which of the following potential issues should the nurse identify that the child is at risk for developing? (Select all that apply.)

Choice A reason: Acidic odors are not a sign of a perforated appendix, but rather a possible indication of gastroesophageal reflux disease (GERD), which is a condition that causes stomach acid to flow back into the esophagus¹.

Choice B reason: Sudden decrease in abdominal pain is a sign of a perforated appendix, which is a serious complication of acute appendicitis. When the appendix ruptures, the pressure inside the abdomen is released, causing a temporary relief of pain. However, this is followed by severe inflammation and infection of the peritoneum, which is the membrane that lines the abdominal cavity². This can lead to sepsis, shock, and death if not treated promptly.

Choice C reason: Narrow fever is not a term that is commonly used in medicine. Fever is a general sign of infection or inflammation, and it can be present in both acute appendicitis and perforated appendix. However, fever alone is not a reliable indicator of the severity or location of the problem³.

Choice D reason: Rigid abdomen is a sign of peritonitis, which is a possible consequence of a perforated appendix. Peritonitis causes the abdominal muscles to contract and become stiff, making the abdomen hard and tender to touch². However, rigidity can also occur in other conditions that cause intra-abdominal inflammation, such as pancreatitis or cholecystitis⁴.

Choice E reason: Nausea is a common symptom of acute appendicitis, but it is not specific to a perforated appendix. Nausea can be caused by irritation of the stomach or the nerves that control vomiting. It can also occur in other gastrointestinal disorders, such as gastritis or gastroenteritis⁵.

Choice A reason: Half-strength orange juice is not a good choice for the infant, as it is acidic and may irritate the gastrointestinal tract. It also does not provide adequate calories or nutrition for the infant.

Choice B reason: Half-strength infant formula is a suitable choice for the infant, as it is bland and easy to digest. It also provides some calories and nutrition for the infant, who may have lost fluids and electrolytes due to the intussusception.

Choice C reason: Full-strength apple juice is not a good choice for the infant, as it is high in sugar and may cause diarrhea. It also does not provide adequate calories or nutrition for the infant.

Choice D reason: Full-strength chicken broth is not a good choice for the infant, as it is high in sodium and may cause dehydration. It also does not provide adequate calories or nutrition for the infant..