A nurse is reviewing the complete blood count results for a child who is receiving treatment for acute lymphoblastic leukemia. Which of the following findings should indicate to the nurse that the treatment is having a therapeutic effect?

- A: Tighten the screws on the halo device one-quarter turn every 48 hr.
- Rationale: This action is incorrect because the screws on a halo device should not be adjusted by the nurse. The screws are typically set and secured by a healthcare provider, and any adjustments can compromise the integrity of the device and the stability of the cervical spine.

- B: Assess the pin sites for infection once every other day.
- Rationale: While it is important to monitor the pin sites for signs of infection, doing so once every other day may not be sufficient. Pin sites should be assessed at least once per shift to ensure early detection and management of any potential infection.

- C: Encourage flexion and extension of the neck.
- Rationale: This action is contraindicated for a client with a halo vest. The purpose of the halo vest is to immobilize the cervical spine to promote healing. Encouraging neck movement could cause further injury or delay healing.

- D: Reposition the client using a turning sheet.
- Rationale: This is the correct action. Using a turning sheet helps to reposition the client safely and effectively without exerting unnecessary pressure on the cervical spine. It also aids in preventing pressure ulcers and promotes comfort for the client.

A. Increased self-esteem is a positive aspect of development, but it may not be a consistent characteristic during early adolescence. Self-esteem can fluctuate based on various factors.

B. Mood swings are common during early adolescence due to hormonal changes and the emotional challenges that come with this stage of development. It's important for parents to be understanding and supportive during this time.

C. The growth rate during early adolescence may vary from person to person, but it generally accelerates rather than decelerates. This period is associated with rapid physical growth, known as the adolescent growth spurt.

D. Emotional separation from parents is a normal part of adolescent development, but it tends to become more prominent in later adolescence rather than early adolescence. During early adolescence, there may be a mix of seeking independence and still relying on parental support and guidance.