A nurse on a pediatric unit is preparing to admit a preschooler after receiving a transfer report from a nurse in the emergency department. Which of the following findings should the nurse report to the provider immediately?

Choice A reason: Leukemia is not a probable condition, as it is a cancer of the white blood cells that causes abnormal proliferation and accumulation of immature or dysfunctional white blood cells. The child has a high WBC count, which can indicate leukemia, but not necessarily. The child does not have other signs of leukemia, such as bleeding, bruising, bone pain, or lymphadenopathy.

Choice B reason: Sickle cell anemia is a possible condition, as it is an inherited disorder that affects the shape and function of the red blood cells, causing them to become sickle-shaped and rigid. The child has a low Hgb and Hct, which can indicate anemia, and a fever, tachycardia, and low oxygen saturation, which can indicate a sickle cell crisis. A sickle cell crisis is a condition where the sickle-shaped red blood cells block the blood flow and cause tissue ischemia and inflammation.

Choice C reason: Hemophilia is not a likely condition, as it is an inherited disorder that affects the clotting factors, causing impaired blood clotting and increased risk of bleeding. The child has a low Hgb and Hct, which can indicate anemia, but not necessarily hemophilia. The child does not have other signs of hemophilia, such as bleeding, bruising, hemarthrosis, or hematuria.

Choice D reason: Iron deficiency anemia is not a definite condition, as it is a type of anemia that occurs when the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the blood. The child has a low Hgb and Hct, which can indicate iron deficiency anemia, but not necessarily. The child does not have other signs of iron deficiency anemia, such as pallor, fatigue, weakness, or pica.

Choice A reason: A 2-year-old toddler is not a recommended recipient of the MCV4 vaccine, as it is not routinely given to children younger than 11 years old, unless they have certain medical conditions that increase their risk of meningococcal disease, such as asplenia, complement deficiency, or HIV infection. A 2-year-old toddler may receive the meningococcal polysaccharide (MPSV4) vaccine instead, if indicated.

Choice B reason: A 4-month-old infant is not a recommended recipient of the MCV4 vaccine, as it is not routinely given to children younger than 11 years old, unless they have certain medical conditions that increase their risk of meningococcal disease, such as asplenia, complement deficiency, or HIV infection. A 4-month-old infant may receive the meningococcal serogroup B (MenB) vaccine instead, if indicated.

Choice C reason: An 11-year-old school-age child is a recommended recipient of the MCV4 vaccine, as it is routinely given to children aged 11 to 12 years old, with a booster dose at age 16. The MCV4 vaccine protects against four types of meningococcal bacteria (A, C, W, and Y) that can cause serious infections of the lining of the brain and spinal cord (meningitis) or the bloodstream (septicemia).

Choice D reason: A 4-year-old child is not a recommended recipient of the MCV4 vaccine, as it is not routinely given to children younger than 11 years old, unless they have certain medical conditions that increase their risk of meningococcal disease, such as asplenia, complement deficiency, or HIV infection. A 4-year-old child may receive the meningococcal polysaccharide (MPSV4) vaccine instead, if indicated.