A child has been diagnosed with acute lymphoblastic leukemia and is being treated with chemotherapy. Because many chemotherapeutic agents cause bone marrow suppression, the nurse, before administering the chemotherapy, will determine if this child has any infection-fighting capability by monitoring the:
Absolute neutrophil count (ANC)
Eosinophils
Red blood cell count (RBC)
Hemoglobin (Hgb)
The Correct Answer is A
A. The absolute neutrophil count (ANC) is the best indicator of a child's ability to fight infection. Neutrophils are a type of white blood cell crucial for fighting bacterial infections, and chemotherapy can suppress bone marrow production of neutrophils. The ANC helps assess the risk for infection and the need for additional precautions, such as infection control.
B. Eosinophils are a type of white blood cell that primarily respond to allergies and parasitic infections, and their count is not used to assess infection risk in chemotherapy patients.
C. The red blood cell count (RBC) is important for assessing oxygen-carrying capacity but does not directly relate to infection-fighting ability.
D. Hemoglobin (Hgb) reflects the oxygen-carrying capacity of the blood, not the body's ability to fight infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Placing the client in a semi-Fowler's position is appropriate to help alleviate pressure on the brain and improve comfort. This position can also help with respiratory function, which may be compromised in meningitis.
B. Admitting the client to a private room is necessary to prevent the spread of the infection to other patients. Bacterial meningitis is highly contagious, and isolation is important to limit exposure.
C. Implementing seizure precautions is essential in managing a child with bacterial meningitis because the infection can cause increased intracranial pressure, which may lead to seizures.
D. Measuring head circumference every shift is unnecessary for this child, as it is typically done for infants to monitor for signs of hydrocephalus or increased intracranial pressure. In a 6-year-old child, clinical signs and imaging studies are more reliable for monitoring ICP.
Correct Answer is C
Explanation
A. Administer antipyretic therapy is appropriate to help reduce fever, but it is not the first priority. The child’s vital signs indicate a high fever and signs of possible meningitis, and intervention to prevent further complications or the spread of infection should take precedence.
B. Place the child in a lateral Sims position is unnecessary in this case. A lateral Sims position is typically used to prevent aspiration during vomiting, but it is not the priority for this child. The focus should be on infection control and stabilizing the child’s condition.
C. Place the child on droplet precautions is the correct priority. The child is showing signs of possible bacterial meningitis, which is a highly contagious infection. Droplet precautions are necessary to prevent transmission of the infection to other individuals.
D. Reduce all environmental stimuli may be helpful for a child with a neurological condition, but it is not the first priority in this case. The priority is preventing the spread of infection while further stabilizing the child’s condition.
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