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 B
Explanation
A. Prevent ear infections: While individuals with cleft palates are at increased risk of ear infections, the primary immediate goal is not ear infection prevention.
B. Establish feeding and sucking.
Clefts of the soft palate can make it challenging for the baby to create a proper seal for sucking and feeding. Ensuring that the baby can feed effectively is a crucial initial goal. This may involve special nipples, bottles, or breastfeeding techniques to help the baby get proper nutrition.
While eventually repairing the cleft palate is an important part of the overall care plan, the immediate goal is to ensure that the baby can feed and gain weight properly.
C. Repair the cleft palate: Surgical repair of the cleft palate is typically done when the child is older. The immediate concern for a newborn is feeding.
D. Help the mother bond with the baby: This is an important aspect of care but not the primary goal for the baby's health and well-being. Bonding can occur while addressing the baby's feeding needs.
Correct Answer is D
Explanation
A. Trientine: Trientine is a medication used to treat copper overload in conditions like Wilson's disease. It is not indicated for iron overdose or toxicity.
B. Dimercaprol: Dimercaprol, also known as BAL (British Anti-Lewisite), is a chelating agent used to treat heavy metal poisoning but is not primarily used for iron overload or toxicity.
C. Ferrous gluconate: Ferrous gluconate is an iron supplement used to treat iron-deficiency anemia by providing additional iron to the body. It is not appropriate for treating iron overdose, as it would worsen the situation.
D. Deferoxamine.
Iron overdose, also known as iron toxicity, can lead to serious complications, including cardiac dysrhythmias. Deferoxamine is a chelating agent used to remove excess iron from the body in cases of iron overload or toxicity, such as in patients with conditions like sickle cell anemia who require frequent blood transfusions. It binds to excess iron and helps excrete it from the body, reducing the risk of iron-related complications, including cardiac issues.
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