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

Hypoglycemia, a condition of low blood glucose (normal range 40-60 mg/dL in neonates), is not prevented by phytonadione (vitamin K). This condition is primarily related to inadequate glucose stores or production, often seen in large or small for gestational age infants or those whose mothers had diabetes. Vitamin K is essential for coagulation factor synthesis, not glucose metabolism regulation.

Choice B rationale

Hyperbilirubinemia, characterized by elevated serum unconjugated bilirubin (jaundice), is not prevented by routine vitamin K administration. This condition results from increased breakdown of fetal red blood cells and the neonate's immature liver function being unable to adequately conjugate and excrete bilirubin. Vitamin K does not directly influence bilirubin processing or excretion pathways.

Choice C rationale

Phytonadione (vitamin K) is administered to neonates to prevent Vitamin K Deficiency Bleeding (VKDB), previously known as hemorrhagic disease of the newborn. Vitamin K is crucial for the liver's synthesis of coagulation factors II, VII, IX, and X. Neonates have low vitamin K stores and insufficient gut flora to produce it, making supplementation necessary to prevent life-threatening bleeding.

Choice D rationale

Polycythemia is an abnormally high concentration of red blood cells (hematocrit > 65.

Choice A rationale

Hemophilia A is a hereditary bleeding disorder caused by a deficiency in coagulation factor VIII. Administering factor X would not correct the underlying deficiency responsible for the child's impaired clot formation, as factor X is a different component of the coagulation cascade and is deficient in factor X deficiency, a distinct disorder.

Choice B rationale

Iron is a crucial component of hemoglobin, and an intravenous infusion of iron is indicated for treating severe iron deficiency anemia. While a child with repeated bleeding episodes could develop anemia, the immediate priority for an acute joint or soft tissue bleed in hemophilia is replacing the deficient clotting factor to stop the hemorrhage.

Choice C rationale

The immediate and definitive treatment for acute bleeding episodes in a child with hemophilia A is the intravenous infusion of the deficient clotting factor, which is factor VIII. Prompt administration helps to control the bleeding into the joint (hemarthrosis), preventing long-term damage and pain.

Choice D rationale

Intramuscular injections are strongly contraindicated in individuals with hemophilia because they pose a significant risk of causing a deep, painful hematoma due to uncontrolled bleeding into the muscle tissue. Iron administration, if needed, should be given orally or intravenously, but not intramuscularly.