A nurse is admitting a child who has leukemia and a critically low platelet count. Which of the following precautions should the nurse initiate?

Neutropenic

Droplet

Bleeding

Contact

Answer and Explanation

The Correct Answer is C

A. Neutropenic Precautions: Neutropenia refers to a low neutrophil count, a type of white blood cell responsible for fighting infections. While children with leukemia are at risk for neutropenia due to the disease and its treatment, the primary concern in this scenario is the critically low platelet count and the risk of bleeding. Neutropenic precautions focus on preventing infections.

B. Droplet Precautions: Droplet precautions are used when dealing with respiratory infections that are transmitted through respiratory droplets, such as coughing or sneezing. This is not the primary concern for a child with leukemia and a low platelet count, as the main risk is bleeding due to the low platelet count.

C. Bleeding Precautions: Leukemia, especially in a child with a critically low platelet count, puts the child at a high risk of bleeding. Platelets are essential for blood clotting, and when they are severely decreased, even minor injuries can lead to excessive bleeding. The nurse should take precautions to minimize the risk of bleeding. This includes avoiding invasive procedures, using a soft toothbrush, and ensuring that the child does not participate in activities that could result in injury.

D. Contact Precautions: Contact precautions are used to prevent the transmission of infectious diseases through direct contact. While a child with leukemia may have a weakened immune system and be at risk of infections, the primary concern in this case is the critically low platelet count and the risk of bleeding. Contact precautions are more relevant in cases of contagious diseases where physical contact could transmit the infection.

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Correct Answer is C

Explanation

In transposition of the great vessels (TGV), the aorta and the pulmonary artery are switched, causing oxygen-rich blood to be pumped back to the lungs and oxygen-poor blood to be pumped out to the body. The ductus arteriosus, a fetal blood vessel that normally closes shortly after birth, allows blood to mix between the two circulations.

Prostaglandin E1 is used to keep the ductus arteriosus open, allowing for a controlled mixing of oxygenated and deoxygenated blood, which can improve oxygen delivery to the body in cases of TGV. This helps maintain oxygenation until corrective surgical interventions can be performed.

The other options, A (decrease pulmonary congestion), B (stimulate the production of red blood cells), and D (increase blood flow to the system), do not accurately describe the primary purpose of Prostaglandin E1 in the context of TGV. The main goal is to maintain a pathway for oxygenated blood to mix with deoxygenated blood to improve oxygen delivery to the body.

A. Shunted past the pulmonary circulation, causing pulmonary hypoxia B. Circulated through the lungs again, causing pulmonary circulatory congestion C. Circulated through the ductus from the pulmonary artery to the aorta bypassing the left side of me heart D. Shunted past cardiac arteries, causing myocardial hypoxia

Correct Answer is C

Explanation

A. Shunted past the pulmonary circulation, causing pulmonary hypoxia: This option is not the primary reason for dyspnea in PDA. While there is shunting, it doesn't directly cause pulmonary hypoxia.

B. Circulated through the lungs again, causing pulmonary circulatory congestion: This option is partially correct but does not address the primary reason for dyspnea, which is the bypassing of the left side of the heart.

C. Circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.

In patent ductus arteriosus (PDA), a fetal blood vessel called the ductus arteriosus fails to close after birth. This allows oxygenated blood from the left atrium to be shunted directly from the aorta to the pulmonary artery, bypassing the normal route through the left side of the heart and into the systemic circulation. The shunting of oxygenated blood back into the pulmonary circulation can lead to increased pulmonary blood flow and circulatory congestion, causing symptoms such as dyspnea.

D. Shunted past cardiac arteries, causing myocardial hypoxia: PDA primarily affects the pulmonary circulation and left side of the heart, not the coronary arteries. Myocardial hypoxia is not the primary mechanism of dyspnea in PDA.

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A nurse is admitting a child who has leukemia and a critically low platelet count. Which of the following precautions should the nurse initiate?

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