A child with leukemia is to receive a unit of platelets.

The child weighs 33 pounds and the platelets are to be transfused at 10 milliliters per kilogram per hour.

The nurse should transfuse the platelets at a rate of how many milliliters per hour? —

Choice A rationale

Using over-the-counter vasoconstrictor eye drops like Visine (tetrahydrozoline) in an infected eye is incorrect and would indicate a need for further teaching. These drops can mask the signs of infection, potentially delay appropriate treatment, and may cause rebound redness or irritation. The primary treatment for bacterial conjunctivitis involves prescribed antibiotic drops or ointment, which should be used instead of symptomatic drops.

Choice B rationale

Washing hands immediately after caring for the child is a crucial intervention and indicates appropriate understanding of infection control. Bacterial conjunctivitis is highly contagious, and meticulous hand hygiene is the most effective measure to prevent the transmission of the infection from the child's eyes to others or to the child's unaffected eye.

Choice C rationale

Encouraging the son to avoid touching his eyes is a correct and vital instruction for managing bacterial conjunctivitis. Touching the infected eye promotes autoinoculation of the unaffected eye and is the primary mechanism for transferring the contagious bacteria to surfaces or other individuals, thus spreading the infection.

Choice D rationale

Using a warm compress to help loosen crust that accumulated on the eyelid overnight is a correct and appropriate comfort measure. The heat and moisture help soften and remove the dried discharge (crusts) that accumulate in bacterial conjunctivitis, making it easier for antibiotic drops to penetrate and for the child to open their eye comfortably.

Choice A rationale

Feeding problems are a common, non-specific finding in early childhood and can be related to many different issues, such as poor latch, reflux, or developmental delays, and are not exclusively indicative of a genetic disorder like Down syndrome. Therefore, this observation is not specific enough to confirm a genetic etiology.

Choice B rationale

Nasal congestion and excess mucus are very common signs of upper respiratory infections or allergic rhinitis in young children. These findings reflect an inflammatory or infectious process in the nasal passages and are not recognized as a primary or specific physical characteristic of a genetic disorder.

Choice C rationale

Low-set ears are a recognized dysmorphic feature or minor congenital anomaly that is often associated with various syndromes, particularly those involving chromosomal abnormalities like Down syndrome, as they reflect atypical fetal development of the first and second branchial arches. Lobe creases, while a potential finding, are less specific than low-set placement.

Choice D rationale

Wheezing suggests obstruction or narrowing in the lower airways, typically associated with conditions like asthma, bronchiolitis, or foreign body aspiration. This is a respiratory symptom related to inflammation and bronchospasm and is not a typical, pathognomonic physical finding of a common genetic disorder.