Which of the following findings should the nurse report to the health care provider immediately? (select all that apply)

Loss of appetite

Platelet count

Developmental regression

Absolute neutrophil count

Hemoglobin

Answer and Explanation

Correct Answer : C,D

Choice A reason: Loss of appetite is not an urgent finding, as it may be caused by various factors, such as nausea, pain, or stress. The nurse should monitor the child's fluid and calorie intake and encourage oral hydration and nutrition. However, loss of appetite does not require immediate reporting to the health care provider.

Choice B reason: Platelet count is not an urgent finding, as it is not given in the text. The nurse should check the child's laboratory results and compare them with the normal ranges for preschoolers. A normal platelet count for children is 150,000 to 450,000 per microliter of blood¹. A low platelet count (thrombocytopenia) may indicate bleeding disorders, infections, or bone marrow problems. A high platelet count (thrombocytosis) may indicate inflammation, infection, or cancer. The nurse should report any abnormal platelet count to the health care provider, but it is not an immediate concern.

Choice C reason: Developmental regression is an urgent finding, as it may indicate a serious neurological problem, such as a brain tumor, infection, or injury. Developmental regression is the loss of previously acquired skills or milestones, such as language, motor, or social skills. The nurse should assess the child's developmental level and report any signs of regression to the health care provider as soon as possible.

Choice D reason: Absolute neutrophil count is an urgent finding, as it may indicate a severe infection or a compromised immune system. Neutrophils are a type of white blood cell that fight bacterial infections. The absolute neutrophil count is the number of neutrophils in a microliter of blood. A normal absolute neutrophil count for children is 1,500 to 8,000 per microliter of blood². A low absolute neutrophil count (neutropenia) may increase the risk of infection and sepsis. A high absolute neutrophil count (neutrophilia) may indicate an acute infection or inflammation. The nurse should report any abnormal absolute neutrophil count to the health care provider immediately.

Choice E reason: Hemoglobin is not an urgent finding, as it is not given in the text. The nurse should check the child's laboratory results and compare them with the normal ranges for preschoolers. Hemoglobin is a protein in red blood cells that carries oxygen. A normal hemoglobin level for children is 11.5 to 15.5 grams per deciliter of blood³. A low hemoglobin level (anemia) may indicate blood loss, iron deficiency, or bone marrow problems. A high hemoglobin level (polycythemia) may indicate dehydration, lung disease, or heart disease. The nurse should report any abnormal hemoglobin level to the health care provider, but it is not an immediate concern.

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Correct Answer is C

Explanation

Choice A reason: Continuing to monitor the client is not the best action, as it does not address the low urine output of the child. The child has a urine output of 20 mL/hr, which is below the expected range of 30 to 40 mL/hr for a 3-year-old child. Low urine output can indicate dehydration, kidney injury, or urinary tract obstruction, which require prompt intervention.

Choice B reason: Performing a bladder scan at the bedside is not the most appropriate action, as it is not the first-line diagnostic tool for low urine output. A bladder scan is a noninvasive ultrasound device that measures the amount of urine in the bladder. It can help detect urinary retention, which is the inability to empty the bladder completely. However, urinary retention is unlikely in a 3-year-old child, and a bladder scan may not be accurate or reliable in children.

Choice C reason: Providing oral rehydration fluids is the best action, as it can help restore the fluid and electrolyte balance of the child. Oral rehydration fluids are solutions that contain water, sugar, and salt in specific proportions that match the body's needs. They can prevent or treat dehydration, which is a common cause of low urine output in children. The nurse should offer the child oral rehydration fluids every 15 to 20 minutes, and monitor the urine output, vital signs, and hydration status.

Choice D reason: Notifying the provider is not the first action, as it is not the most urgent or effective intervention for low urine output. The nurse should notify the provider after providing oral rehydration fluids and assessing the child's response. The nurse should also report any signs or symptoms of dehydration, such as dry mucous membranes, sunken eyes, poor skin turgor, or lethargy. The provider may order further tests or treatments, such as blood tests, urine tests, or intravenous fluids.

A. The quality of food I provide him is more important than the quantity. B. I should expect him to have an increased appetite. C. Because he is such a picky eater, I will give him one of my vitamins each day. D. His average daily intake should be about 3,000 calories.

Correct Answer is A

Explanation

Choice A reason: This statement shows that the parents understand that toddlers need a balanced diet that includes a variety of foods from different food groups. The quality of food is more important than the quantity, as toddlers may have erratic eating patterns and may not consume large amounts of food at one time.

Choice B reason: This statement is incorrect, as toddlers typically have a decreased appetite compared to infants. This is due to their slower growth rate and increased interest in other activities. Parents should not force their toddlers to eat more than they want, but rather offer them healthy snacks and meals throughout the day.

Choice C reason: This statement is incorrect, as toddlers do not need vitamin supplements unless they have a specific deficiency or medical condition. Giving vitamins to a picky eater may not address the underlying causes of their food preferences, such as texture, taste, or appearance. Parents should encourage their toddlers to try new foods and avoid using food as a reward or punishment.

Choice D reason: This statement is incorrect, as toddlers do not need 3,000 calories per day. The average daily caloric intake for a toddler is about 1,000 to 1,400 calories, depending on their age, weight, and activity level. Parents should not overfeed their toddlers or give them high-calorie foods that may lead to obesity or malnutrition.

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Which of the following findings should the nurse report to the health care provider immediately? (select all that apply)

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