A school nurse is assessing a 7-year-old student.
The nurse should identify which of the following findings as a potential indicator of physical abuse?

Choice A rationale

Initiating bleeding precautions is an important action when caring for a child with acute lymphocytic leukemia. These patients are at increased risk of bleeding due to decreased platelet counts.

Choice B rationale

Placing the child in a knee-chest position is not typically necessary in the care of a child with acute lymphocytic leukemia.

Choice C rationale

Applying viscous lidocaine to the oral mucosa is not typically necessary in the care of a child with acute lymphocytic leukemia.

Choice D rationale

Obtaining a rectal temperature every 4 hours is not typically necessary in the care of a child with acute lymphocytic leukemia. However, regular monitoring of the child’s temperature is important to detect any signs of infection.

Choice A rationale

Initiating contact precautions is not necessary for a child experiencing a sickle cell crisis. Sickle cell disease is not contagious and does not require isolation precautions.

Choice B rationale

Applying warm compresses to the affected area can help increase blood flow and reduce pain during a sickle cell crisis. Warmth can help dilate blood vessels, allowing more blood to reach the affected area and reducing the blockage caused by the sickle cells.

Choice C rationale

Decreasing the child’s fluid intake is not recommended during a sickle cell crisis. In fact, it’s important to encourage fluid intake to prevent dehydration, which can worsen the crisis.

Choice D rationale

Administering furosemide IV twice per day is not typically part of the treatment plan for a sickle cell crisis. Furosemide is a diuretic, which could potentially lead to dehydration, worsening the crisis.