Nursing care of a child who is immunosuppressed due to leukemia or chemotherapeutic agents should include:
(choose one best answer)
Have them share a room with a child with active mumps
Restrict oral fluids
Strict isolation
Use good handwashing
The Correct Answer is D
Choice A reason: This choice is incorrect because having them share a room with a child with active mumps may expose them to infection and worsen their condition. A child who is immunosuppressed due to leukemia or chemotherapeutic agents has a weakened immune system and is more susceptible to infections from bacteria, viruses, fungi, or parasites. Therefore, they should be placed in a private room or cohorted with another immunosuppressed child.
Choice B reason: This choice is incorrect because restricting oral fluids may cause dehydration and electrolyte imbalance in the child who is immunosuppressed due to leukemia or chemotherapeutic agents. A child who is immunosuppressed due to leukemia or chemotherapeutic agents may have increased fluid losses from vomiting, diarrhea, fever, or sweating. Therefore, they should be encouraged to drink adequate fluids to maintain hydration and electrolyte balance.
Choice C reason: This choice is incorrect because strict isolation may cause psychological distress and social isolation in the child who is immunosuppressed due to leukemia or chemotherapeutic agents. A child who is immunosuppressed due to leukemia or chemotherapeutic agents may benefit from protective isolation, which involves using standard precautions and additional measures such as wearing gloves, gowns, masks, or eye protection when in contact with the child or their body fluids. However, strict isolation, which involves limiting visitors and activities, may harm the child's emotional and developmental well-being.
Choice D reason: This choice is correct because using good handwashing is essential nursing care for a child who is immunosuppressed due to leukemia or chemotherapeutic agents. Handwashing is the most effective way to prevent the transmission of microorganisms that can cause infections. The nurse should wash their hands before and after touching the child or their belongings, and teach the child and their family members to do the same. The nurse should also use alcohol-based hand rubs when water and soap are not available.
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Related Questions
Correct Answer is B
Explanation
Choice A reason: This choice is incorrect because mumps is not the common name for pertussis. Mumps is a viral infection that causes inflammation of the salivary glands, especially the parotid glands. It may cause symptoms such as fever, headache, and swelling of the cheeks or jaw. It can be prevented by vaccination with the measles-mumps-rubella (MMR) vaccine.
Choice B reason: This choice is correct because whooping cough is the common name for pertussis. Pertussis is a bacterial infection that causes severe coughing spells, which may be followed by a high-pitched whoop sound or vomiting. It may cause complications such as pneumonia, seizures, or brain damage, especially in infants and young children. It can be prevented by vaccination with the diphtheria-tetanus-pertussis (DTaP) vaccine.
Choice C reason: This choice is incorrect because the fifth disease is not the common name for pertussis. The fifth disease is a viral infection that causes a rash on the face, trunk, and limbs, which may resemble a slapped cheek appearance. It may cause mild symptoms such as fever, runny nose, or joint pain. It usually affects children and is self-limiting.
Choice D reason: This choice is incorrect because chickenpox is not the common name for pertussis. Chickenpox is a viral infection that causes an itchy rash with fluid-filled blisters all over the body. It may cause symptoms such as fever, headache, or loss of appetite. It can be prevented by vaccination with the varicella-zoster (VZV) vaccine.
Correct Answer is D
Explanation
Choice A: This instruction is incorrect, as withholding insulin dose if feeling nauseous can cause hyperglycemia, which is high blood sugar, and diabetic ketoacidosis, which is a life-threatening condition that occurs when the body breaks down fat for energy and produces ketones. Ketones are acidic substances that can cause nausea, vomiting, abdominal pain, dehydration, or coma. The child should take their insulin dose as prescribed and monitor their blood sugar levels more frequently when they are sick.
Choice B: This instruction is unnecessary, as notifying the provider if blood glucose levels are within normal parameters does not require any action or intervention. The child and the parents should notify the provider if blood glucose levels are above or below the target range, which is usually 70 to 180 mg/dL for children with type 1 diabetes mellitus. The child and the parents should also notify the provider if they have any signs or symptoms of hypoglycemia, hyperglycemia, or diabetic ketoacidosis.
Choice C: This instruction is incorrect, as limiting fluid intake during mealtime can cause dehydration, which can worsen the symptoms and complications of type 1 diabetes mellitus. Dehydration can cause increased thirst, dry mouth, fatigue, headache, or dizziness. The child should drink plenty of fluids during meal time and throughout the day to hydrate their body and flush out excess glucose and ketones.
Choice D: This instruction is correct, as testing the urine for ketones can help detect diabetic ketoacidosis, which is a life-threatening condition that occurs when the body breaks down fat for energy and produces ketones. Ketones are acidic substances that can cause nausea, vomiting, abdominal pain, dehydration, or coma. The child should test their urine for ketones when their blood sugar levels are above 240 mg/dL or when they are sick. The child and the parents should notify the provider if the urine test shows moderate or large amounts of ketones.
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