A nurse is caring for a child with newly diagnosed acute lymphoblastic leukemia. What clinical findings does the nurse anticipate when assessing the child? Select all that apply.
Fatigue
Generalized edema
Pallor
Jaundice
Multiple bruises
Correct Answer : A,C,E
A. Fatigue: Children with ALL often experience fatigue and weakness due to decreased red blood cell and platelet production as a result of bone marrow involvement by leukemia cells.
C. Pallor: Pallor, or paleness, is a common finding in children with ALL because of anemia (reduced red blood cell count).
E. Multiple bruises: Children with ALL may have an increased tendency to bruise and bleed due to low platelet counts, making them susceptible to easy bruising and petechiae.
The other options, B (Generalized edema) and D (Jaundice), are not typical clinical findings associated with ALL. Generalized edema is not a common symptom, and jaundice (yellowing of the skin and eyes) is more commonly associated with liver conditions, not leukemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A.Altered level of consciousness and thready pulse.
In a child after heart surgery to correct Tetralogy of Fallot (TOF), a thready pulse and altered level of consciousness can be indicative of poor cardiac output. This may suggest that the heart is not effectively pumping blood to meet the body's needs.
B. Bounding pulses and mottled skin: Bounding pulses and mottled skin are not typical signs of decreased cardiac output. Bounding pulses are often associated with increased cardiac output.
C. Capillary refill of 2 seconds and blood pressure of 96/47 mmHg: A capillary refill of 2 seconds is within the normal range, and a blood pressure of 96/47 mmHg is reasonable for a child. These findings do not necessarily indicate poor cardiac output.
D. Extremities warm to the touch and pale skin: Warm extremities and pale skin are not typical signs of decreased cardiac output. Cold extremities and cyanosis may be more concerning signs.
Correct Answer is C
Explanation
A. Varying the child's schedule each day may add unnecessary stress and disrupt the child's sense of routine and stability, which is important during a hospitalization.
B. Providing a daily session with a play therapist may be valuable but does not directly address the child's developmental need for competence and mastery.
C. Encourage the client to complete school work.
Erikson's psychosocial stage theory suggests that children at the age of 10 are in the "Industry vs. Inferiority" stage. During this stage, children strive to develop a sense of competence and mastery in various activities. Encouraging the child to complete school work aligns with this stage, as it fosters a sense of accomplishment, competence, and success, which is crucial for their psychosocial development.
D. Discouraging visits from the client's friends would not support the child's social and emotional well-being during the hospitalization, and social connections are important for psychosocial development.
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