A nurse is caring for a child who has a new diagnosis of immune thrombocytopenia. Which of the following information regarding implications of the diagnosis should the nurse reinforce in the discharge instructions?

Children with immune thrombocytopenia should not partake in physical activity.

Children with immune thrombocytopenia have a lower risk of bleeding.

Thrombocytopenia is a chronic disease in children.

Children with a history of thrombocytopenia have a higher incidence of bleeding.

Answer and Explanation

The Correct Answer is D

A. Children with immune thrombocytopenia should not partake in physical activity. While children with severe thrombocytopenia should avoid high-impact or contact sports, complete restriction from physical activity is unnecessary. Low-risk activities can be encouraged to support overall health.

B. Children with immune thrombocytopenia have a lower risk of bleeding. This is incorrect. Thrombocytopenia is characterized by low platelet levels, which increase the risk of bleeding and bruising, making injury prevention crucial.

C. Thrombocytopenia is a chronic disease in children. Immune thrombocytopenia (ITP) can be acute or chronic, but in most children, it is a self-limiting condition that resolves within months. Chronic ITP is less common but does occur in some cases.

D. Children with a history of thrombocytopenia have a higher incidence of bleeding. This is correct. Low platelet counts impair blood clotting, increasing the risk of spontaneous bruising, nosebleeds, and prolonged bleeding from minor injuries. Parents should monitor for signs of bleeding and avoid medications like aspirin or NSAIDs that can worsen bleeding risk.

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Correct Answer is B

Explanation

A. "Palliative care should be given separately from curative care." Palliative care can be provided alongside curative treatments to enhance comfort and quality of life. It is not limited to end-of-life care but focuses on symptom management and emotional support throughout the illness.

B. "Clinicians should participate in the discussion with the family about the child's prognosis." Open, honest, and compassionate communication between healthcare providers and families is crucial. Clinicians help families understand the prognosis, treatment options, and goals of care, ensuring informed decision-making.

C. "Parents who express hope of their child surviving are less accepting of palliative care." Parents can hope for a cure while still accepting palliative care to improve their child's comfort and quality of life. Hope and palliative care are not mutually exclusive.

D. "Palliative care should be offered once a child has less than 6 months to live." Palliative care is not limited to a specific timeframe. It can begin at diagnosis of a serious illness and continue throughout treatment, rather than being restricted to end-of-life care.

A. Cardiac enzymes B. Complete blood count C. Blood coagulation tests D. Arterial blood gases

Correct Answer is B

Explanation

A. Cardiac enzymes. Cardiac enzyme tests are used to assess heart damage, such as in myocardial infarction, and are not typically relevant in evaluating a child's nutritional status.

B. Complete blood count. A CBC is a key diagnostic test for assessing nutritional status, as it can reveal anemia (low hemoglobin and hematocrit), infection (elevated white blood cells), and overall health status. It helps identify deficiencies in iron, folate, and vitamin B12, which are common nutritional concerns in children.

C. Blood coagulation tests. Coagulation tests (e.g., PT, INR, aPTT) are used to assess blood clotting disorders and monitor anticoagulant therapy, but they are not standard tests for nutritional assessment unless there is suspicion of a vitamin K deficiency.

D. Arterial blood gases. ABG tests assess respiratory function and acid-base balance, which are more relevant in critically ill patients. They are not routinely used to evaluate a child's nutritional status.

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A nurse is caring for a child who has a new diagnosis of immune thrombocytopenia. Which of the following information regarding implications of the diagnosis should the nurse reinforce in the discharge instructions?

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