A nurse is caring for an 18-month-old toddler in the emergency department. The nurse reviews the toddler's medical record and assessment findings. Which of the following provider prescriptions should the nurse anticipate?

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: This is the most likely source of the child's infection. Rheumatic fever is a complication of an untreated or poorly treated streptococcal infection, such as strep throat or scarlet fever. It usually occurs 2 to 4 weeks after the initial infection and causes inflammation of the heart, joints, skin, and nervous system. The nurse should ask the parent if the sibling was tested and treated for strep throat, and if the child was exposed to the sibling.

Choice B reason: This is not a likely source of the child's infection. Chickenpox is caused by the varicella-zoster virus, not by streptococci. It is a highly contagious disease that causes a blister-like rash, itching, fever, and fatigue. It does not cause rheumatic fever, but it can lead to other complications, such as bacterial skin infections, pneumonia, or encephalitis.

Choice C reason: This is not a likely source of the child's infection. Fifth disease is caused by the parvovirus B19, not by streptococci. It is a mild illness that causes a distinctive red rash on the face, body, and limbs, as well as fever, headache, and sore throat. It does not cause rheumatic fever, but it can affect the production of red blood cells and cause anemia in some people.

Choice D reason: This is not a likely source of the child's infection. Gastritis is the inflammation of the stomach lining, which can be caused by various factors, such as bacteria, viruses, medications, alcohol, or stress. It is not caused by streptococci, nor does it cause rheumatic fever. It can cause symptoms such as abdominal pain, nausea, vomiting, and loss of appetite.