A nurse is reviewing the laboratory values of an eight-month-old infant who is newly diagnosed with leukemia. Their most recent platelet count is 120,000/mm3 (200,000 to 475,000/mm3). Which of the following provider prescriptions should the nurse anticipate?

Administer packed red blood cells transfusion (PRBC)

Avoid taking rectal temperatures

Place child in protective environment precautions

Swab the oral cavity with viscous lidocaine

Answer and Explanation

The Correct Answer is B

A. Administer packed red blood cells transfusion (PRBC):

While anemia may also be a concern in leukemia, the primary issue here is thrombocytopenia, not anemia. Administering packed red blood cells transfusion would address anemia, not the low platelet count.

B. Avoid taking rectal temperatures:

This is the correct option. Taking rectal temperatures carries the risk of causing bleeding or trauma, especially in individuals with thrombocytopenia. It is essential to avoid invasive procedures or activities that may increase the risk of bleeding in a patient with a low platelet count.

C. Place child in protective environment precautions:

Protective environment precautions, also known as reverse isolation, are typically implemented for patients who are immunocompromised to protect them from exposure to infectious agents. While patients with leukemia may be immunocompromised, the low platelet count is the primary concern here, not infection risk.

D. Swab the oral cavity with viscous lidocaine:

Swabbing the oral cavity with viscous lidocaine is not indicated for thrombocytopenia. Lidocaine may have local anesthetic properties but does not address the underlying issue of low platelet count.

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Correct Answer is D

Explanation

A. FACES: The FACES pain scale is a visual analog scale commonly used with older children who can point to or select a facial expression that best represents their pain level. It may not be suitable for infants who may not have the cognitive or motor skills to use the scale effectively.

B. COMFORT: The COMFORT scale assesses pain in infants and young children based on behaviors such as crying, facial expressions, and body movements. It evaluates parameters such as alertness, calmness, respiratory response, physical movement, and muscle tone. The COMFORT scale is suitable for assessing pain in infants and young children, including those who are postoperative.

C. CRIES: The CRIES scale is a neonatal pain assessment tool that evaluates crying, oxygen saturation, vital signs, expression, and sleeplessness. While it is designed for newborns and infants up to 6 months of age, it may not be as appropriate for a 12-month-old infant who is postoperative and beyond the neonatal period.

D. FLACC: The FLACC scale assesses pain in infants and young children based on five behavioral categories: facial expression, leg movement, activity level, cry, and consolability. It is commonly used in pediatric settings and is suitable for assessing pain in infants who are postoperative.

A. Coarctation of the aorta B. Patent ductus arteriosus C. Tetralogy of Fallot D. Tricuspid atresia

Correct Answer is B

Explanation

A. Coarctation of the aorta

Coarctation of the aorta involves a narrowing of the aorta, leading to decreased blood flow to the lower body. It is not associated with increased pulmonary blood flow.

B. Patent ductus arteriosus

Patent ductus arteriosus (PDA) is a congenital heart defect where the ductus arteriosus, a fetal blood vessel that usually closes shortly after birth, remains open. This allows blood to flow from the aorta into the pulmonary artery, increasing pulmonary blood flow. Therefore, option B is correct.

C. Tetralogy of Fallot

Tetralogy of Fallot is a congenital heart defect characterized by four abnormalities, including a ventricular septal defect (VSD), pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. While it can lead to cyanosis due to right-to-left shunting, it is not primarily associated with increased pulmonary blood flow.

D. Tricuspid atresia

Tricuspid atresia involves the absence of the tricuspid valve, leading to a lack of direct blood flow from the right atrium to the right ventricle. It usually presents with decreased pulmonary blood flow rather than increased pulmonary blood flow.

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A nurse is reviewing the laboratory values of an eight-month-old infant who is newly diagnosed with leukemia. Their most recent platelet count is 120,000/mm3 (200,000 to 475,000/mm3). Which of the following provider prescriptions should the nurse anticipate?

Nursing Test Bank

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