A nurse is caring for a toddler whose parent states that while bathing the child, she noticed a mass in his abdominal area and that his urine is a pink color. Which of the following actions is the nurse's priority?

Choice A reason: Hemorrhage is a potential issue for a child who has leukemia, as it is a condition that causes excessive bleeding, which can be caused by thrombocytopenia, coagulopathy, or bone marrow suppression. Leukemia can cause a low platelet count, which impairs the blood clotting process and increases the risk of bleeding from minor injuries, mucous membranes, or internal organs.

Choice B reason: Peripheral neuropathy is a potential issue for a child who has leukemia, as it is a condition that affects the nerves, which can be caused by chemotherapy, radiation, infection, or compression. Leukemia can cause nerve damage, which can result in numbness, tingling, pain, or weakness in the extremities, face, or trunk.

Choice C reason: Priapism is not a potential issue for a child who has leukemia, as it is a condition that causes a prolonged and painful erection of the penis, which can be caused by sickle cell disease, medication, trauma, or spinal cord injury. Leukemia does not affect the penis, but it can cause testicular pain, swelling, or masses due to leukemic infiltration.

Choice D reason: Tumor lysis syndrome is a potential issue for a child who has leukemia, as it is a condition that causes a rapid release of cellular contents into the bloodstream, which can be caused by chemotherapy, radiation, or spontaneous tumor breakdown. Tumor lysis syndrome can cause electrolyte imbalance, metabolic acidosis, renal failure, or cardiac arrhythmias.

Choice A reason: Keeping the baby in an upright position after feedings is an effective strategy to prevent or reduce gastroesophageal reflux, as it allows gravity to help the stomach contents stay down. The parent should hold the baby upright for at least 20 to 30 minutes after each feeding, and avoid placing the baby in a car seat or swing, which can increase the abdominal pressure.

Choice B reason: Feeding the baby formula rather than breast milk is not necessary for gastroesophageal reflux, as breast milk is easier to digest and less likely to cause reflux than formula. The parent should continue to breastfeed the baby, unless there is a medical reason to switch to formula. The parent should also avoid overfeeding the baby, and burp the baby frequently during and after feedings.

Choice C reason: Positioning the baby lying on his stomach is not recommended for gastroesophageal reflux, as it can increase the risk of aspiration, suffocation, and sudden infant death syndrome (SIDS). The parent should place the baby on his back to sleep, and elevate the head of the crib or bassinet by 30 degrees to reduce the reflux.

Choice D reason: Thickening the baby's formula with honey is not advised for gastroesophageal reflux, as honey can cause botulism, a serious and potentially fatal illness, in infants under one year of age. The parent should not add any thickening agents to the formula, unless prescribed by the provider. Some studies suggest that thickening the formula with rice cereal may reduce the reflux, but the evidence is inconclusive and the practice may have adverse effects, such as increased caloric intake, constipation, or food allergies.