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A pediatric nurse is assisting with the care of a school-age child who has leukemia.

Exhibits
Which of the following data collection findings should the nurse report to the provider? Select the 5 findings that should be reported to the provider.

A.

Blood pressure

B.

Skin assessment

C.

Breath sounds

D.

Oxygen saturation

E.

WBC count

F.

Retractions

G.

Respiratory rate

H.

Hemoglobin

Answer and Explanation

Correct Answer : B,C,D,F,G

A. Blood pressure: The blood pressure is within normal limits and does not indicate an acute issue in this context.

B. Skin assessment: The presence of pallor and bruising indicates potential anemia and thrombocytopenia, common in leukemia patients but concerning signs that need to be monitored.

C. Breath sounds: Rhonchi in the upper lobes suggest respiratory congestion or infection, which is dangerous in an immunocompromised child.

D. Oxygen saturation: A drop in oxygen saturation to 90% indicates impaired oxygenation, which could signify respiratory distress or worsening infection.

E. WBC count: Although WBC count is within the low-normal range, it does not independently indicate an immediate change in the child’s condition.

F. Retractions: Subcostal retractions indicate respiratory distress, which is critical to report as it could escalate quickly in a child.

G. Respiratory rate: The increased respiratory rate (from 22 to 30/min) reflects respiratory distress and may worsen if the infection progresses.

H. Hemoglobin: While low, the hemoglobin is not acutely life-threatening in this case and would not necessarily prompt urgent intervention without other symptoms.


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Related Questions

Correct Answer is ["1610"]

Explanation

Solution:

  1. Convert ounces to milliliters (1 oz = 30 mL):
    • Coffee: 8 oz × 30 mL = 240 mL
    • Juice: 3 oz × 30 mL = 90 mL
    • Soda: 12 oz × 30 mL = 360 mL
  2. Calculate water intake:
    • Initial pitcher: 800 mL
    • Remaining: 200 mL
    • Water intake = 800 mL - 200 mL = 600 mL
  3. Calculate IV fluids intake:
    • IV rate: 40 mL/hr
    • Time: 8 hours
    • IV fluids = 40 mL/hr × 8 hrs = 320 mL
  4. Total intake:
    • 240 mL (coffee) + 90 mL (juice) + 360 mL (soda) + 600 mL (water) + 320 mL (IV) = 1610 mL

Answer: 1610 mL

Correct Answer is B

Explanation

A. WBCs: White blood cell counts may vary in multiple myeloma, but they are not typically increased; in fact, WBC counts can be low due to bone marrow crowding.

B. Calcium: Multiple myeloma often causes hypercalcemia because of increased bone breakdown, leading to the release of calcium into the bloodstream.

C. Absolute neutrophil count: The absolute neutrophil count may actually decrease as a result of bone marrow dysfunction, not increase.

D. Platelets: Platelet counts are often decreased in multiple myeloma due to bone marrow involvement, not increased.

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