A nurse is reinforcing teaching with the guardians of a preschooler who has leukemia. The nurse should identify that which of the following educational topics is the priority to include?

• Steatorrhea: Steatorrhea (fatty stools) is a common symptom of cystic fibrosis due to pancreatic insufficiency. It is not directly related to the current acute infection (Streptococcus pneumonia).
• Barrel chest: A barrel chest is a chronic sign of cystic fibrosis caused by long-standing lung disease and airway obstruction. It is not related to the acute infection (Streptococcus pneumonia) but reflects the long-term effects of cystic fibrosis.
• Hemoptysis 300 mL: Hemoptysis, 300 mL, is a significant and concerning sign of potential worsening condition. While blood-streaked sputum was initially noted, a large volume like 300 mL indicates significant bleeding from the lungs.
• WBC count 17,000/mm³: The initial WBC count was 22,000/mm3, indicating an active bacterial infection. A decrease to 17,000/mm3, while still elevated, suggests that the body's inflammatory response is potentially improving and that the infection IS responding to treatment.
• Oxygen saturation 95% on 1 L oxygen via nasal cannula: The oxygen saturation has improved (from 92% to 95%) with a reduction in the amount of supplemental oxygen, indicating that the patient’s respiratory status is improving.
• Respiratory rate 32/min: The respiratory rate has decreased slightly from 36/min to 32/min, indicating that the patient’s breathing is becoming more stable as the condition improves. However, respiratory rate should still be closely monitored as part of overall progress.

A. "I will collect the first drop of blood by wiping it on the test strip." The first drop of blood should be wiped away with a clean cotton ball or gauze. This is because the first drop can contain interstitial fluid that may dilute the sample and lead to an inaccurate reading.
B. "I will stick the side of my finger with the lancet instead of the center." Sticking the side of the fingertip is less painful and allows for better blood flow compared to the center of the fingertip, which is often more sensitive.
C. “I will hold the lancet at a 45-degree angle when piercing my skin.” The lancet should typically be held at a 90-degree angle (straight) when piercing the skin, not at a 45-degree angle. A correct angle ensures proper blood flow and reduces discomfort.
D. “I will place my finger under cool water for a few seconds before the stick.” Using cool water before testing can cause the blood vessels to constrict. Warm water is recommended before testing, as it helps increase blood flow and makes it easier to obtain a sample.