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

Option A (Place the infant in reverse Trendelenburg position) and option B (Place the infant in the knee to chest position) are not the immediate actions to address this situation. While these positions might be used in specific situations, assessing blood pressure is more appropriate in this context to evaluate for potential vascular issues.

Option C. Take the infant's blood pressure in all extremities.

In an infant with weaker femoral pulses compared to the brachial and radial pulses, there might be a concern about coarctation of the aorta (a narrowing of the aorta), which can affect blood flow to the lower extremities. To confirm this and assess for potential issues, taking blood pressure measurements in all four extremities is crucial. This comparison can help identify pressure differentials between the upper and lower extremities, which is a hallmark sign of coarctation of the aorta.

Option D (Notify the Physician) is generally a good step, but taking the blood pressure in all extremities should be done first to provide comprehensive information for the physician when discussing the infant's condition.

A. Dress the child in woolen clothes during cold months. B. Launder the child's clothing with fabric softener C. Apply a topical corticosteroid ointment to the affected area. D. Give the child a bubble baths every day

Correct Answer is C

Explanation

A. Dress the child in woolen clothes during cold months: Wool can be irritating to the skin and may worsen eczema symptoms. Cotton or soft fabrics are typically better choices.

B. Launder the child's clothing with fabric softener: Fabric softeners often contain chemicals that can irritate the skin. It's best to use fragrance-free and hypoallergenic detergents and skip fabric softeners.

C. Apply a topical corticosteroid ointment to the affected area.

When teaching a parent of a preschooler with eczema, it's essential to provide guidance on appropriate treatments. Applying a topical corticosteroid ointment is an effective approach for managing eczema symptoms. These medications can help reduce inflammation and itching, which are common in eczema. However, it's crucial for the parent to use them as directed by a healthcare provider and not excessively.

D. Give the child a bubble bath every day: Frequent bathing, especially with bubble baths, can dry out the skin and worsen eczema. It's usually better to limit baths and use gentle, fragrance-free cleansers.

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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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