An adolescent experiencing a vaso-occlusive crisis reports right knee pain. Which is the most appropriate intervention?

A. Fatigue: Children with ALL often experience fatigue and weakness due to decreased red blood cell and platelet production as a result of bone marrow involvement by leukemia cells.

C. Pallor: Pallor, or paleness, is a common finding in children with ALL because of anemia (reduced red blood cell count).

E. Multiple bruises: Children with ALL may have an increased tendency to bruise and bleed due to low platelet counts, making them susceptible to easy bruising and petechiae.

The other options, B (Generalized edema) and D (Jaundice), are not typical clinical findings associated with ALL. Generalized edema is not a common symptom, and jaundice (yellowing of the skin and eyes) is more commonly associated with liver conditions, not leukemia.

A. Administration of a systemic oral antibiotic and a topical antibiotic may be used, but this option does not address the removal of crusts, which is essential for preventing complications.

B. Administration of a systemic and a topical antifungal is not appropriate for impetigo, as impetigo is caused by bacteria, not fungi.

C. Using an oil-based soap for bathing is not recommended, as it may not effectively remove crusts and pustules associated with impetigo, and it does not have antimicrobial properties necessary for treatment.

D. Removal of crusts with an antimicrobial liquid.

Impetigo is a contagious bacterial skin infection, typically caused by Staphylococcus aureus or Streptococcus pyogenes. It often presents with crusts and pustules on the skin. To prevent complications, it's important to keep the affected areas clean and free from crusts. Gently removing crusts with an antimicrobial liquid and clean cloth helps prevent the spread of infection, allows topical antibiotics to work effectively, and reduces the risk of complications.