Exhibits

A nurse is caring for a client in the emergency department (ED). Which of the following actions should the nurse take? Select all that apply.

Rationale for Correct Answers:

• LDL level: An LDL level of 145 mg/dL exceeds the recommended limit (<130 mg/dL), increasing the client’s risk for atherosclerosis and coronary artery disease. Elevated LDL contributes to plaque buildup in arterial walls, narrowing the vessels and raising the likelihood of myocardial infarction and stroke.
• BMI: A BMI of 29.8 falls in the overweight range (25–29.9), nearing obesity. Excess body weight, particularly visceral fat, is associated with hypertension, insulin resistance, and dyslipidemia, all of which are significant risk factors for cardiovascular disease.

Rationale for Incorrect Answers:

• Exercise: The client walks 30 minutes 5 days a week, meeting the American Heart Association’s guidelines for physical activity. Regular aerobic exercise reduces blood pressure, improves lipid profiles, and strengthens cardiac function.
• Diet: The client reports following a Mediterranean diet, which is associated with lower cardiovascular risk due to its emphasis on fruits, vegetables, whole grains, lean protein, and healthy fats. Although wine consumption is noted, moderation aligns with Mediterranean patterns.
• HDL level: The client’s HDL is 58 mg/dL, which is above the desired threshold (>55 mg/dL). Higher HDL levels offer cardioprotective effects by helping remove cholesterol from the bloodstream and reducing the risk of plaque buildup.

A. Initiate a low-protein diet for the child: A low-protein diet is not indicated for neutropenia and may impair healing and immune function. Adequate nutrition, including sufficient protein, supports recovery and immune response.
B. Screen the child's visitors for active infections: Neutropenia significantly increases the risk of infection due to low white blood cell counts, so screening visitors for active infections helps reduce the chance of exposing the child to infectious agents.
C. Monitor the child for indications of active bleeding: While bleeding risk is important in leukemia, neutropenia specifically refers to decreased neutrophils affecting infection risk rather than platelets, so bleeding monitoring is important but not the primary focus here.
D. Prepare the child for a platelet transfusion: Platelet transfusions are used to address thrombocytopenia, not neutropenia. Transfusions may be needed in leukemia but are not directly related to neutropenia care.