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A nurse is assisting with the care of a 7-year-old child.

Exhibits
The nurse is reviewing the data collection findings and diagnostic results. For each data collection finding, click to specify if the finding is consistent with leukemia, sickle cell anemia, or hemophilia. Each finding may support more than 1 disease process.

A.

Reported pain

B.

Bleeding

C.

Temperature

D.

Bruising

E.

WBC count

Answer and Explanation

The Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,C"},"C":{"answers":"A,B"},"D":{"answers":"A"},"E":{"answers":"A"}}

Reported pain

  • Leukemia: Possible, as bone pain can occur due to marrow involvement.
  • Sickle Cell Anemia: Yes, common due to vaso-occlusive crises.
  • Hemophilia: No, hemophilia typically causes bleeding rather than pain from blood cell abnormalities.

Bleeding

  • Leukemia: Yes, due to thrombocytopenia.
  • Sickle Cell Anemia: No, bleeding is not typical in sickle cell crises.
  • Hemophilia: Yes, hemophilia is a bleeding disorder due to a clotting factor deficiency.

Temperature

  • Leukemia: Yes, fever can indicate infection due to immunosuppression.
  • Sickle Cell Anemia: Yes, fever can be a sign of infection during crises.
  • Hemophilia: No, hemophilia does not cause fever unless there is an infection.

Bruising

  • Leukemia: Yes, thrombocytopenia can lead to easy bruising.
  • Sickle Cell Anemia: No, bruising is not typical in sickle cell crises.
  • Hemophilia: Yes, due to a clotting factor deficiency, easy bruising is common.

WBC count

  • Leukemia: Yes, often elevated due to immature or abnormal white cells.
  • Sickle Cell Anemia: No, WBC count is usually normal unless there is an infection.
  • Hemophilia: No, WBC count is typically normal in hemophilia.


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Related Questions

Correct Answer is A

Explanation

A. The patient should increase intake of fluids. Increased fluid intake helps flush excess calcium from the kidneys, which is vital for patients with hypercalcemia, a common complication of multiple myeloma.

B. The patient should increase intake of fresh fruits. Fresh fruits can be healthy but do not directly reduce hypercalcemia risk. Fluid intake is more critical in preventing calcium build up.

C. The patient should decrease intake of red meat. While reducing red meat can be beneficial for overall health, it does not directly address hypercalcemia.

D. The patient should avoid alcoholic beverages. Avoiding alcohol is generally beneficial, but it is not specifically related to managing hypercalcemia in multiple myeloma.

Correct Answer is D

Explanation

A. Hematocrit 35% (F 37%–47%; M 42%–52%): Although the hematocrit is slightly low, it is not as concerning as a low platelet count, which poses an immediate risk for bleeding.

B. Bone pain: Bone pain is common in leukemia due to bone marrow expansion, but it does not take priority over the risk of bleeding from thrombocytopenia.

C. Weight loss: Weight loss may be a symptom of leukemia, but it is not immediately life-threatening and does not take priority over a low platelet count that increases bleeding risk.

D. Platelet count 125,000/mm³ (150,000–400,000): A low platelet count is concerning in leukemia patients because it increases the risk of bleeding. Monitoring for and preventing bleeding is a high priority due to thrombocytopenia associated with leukemia.

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