A nurse is planning care for a child who has neutropenia due to leukemia. Which of the following interventions should the nurse include in the plan of care?
Screen the child's visitors for active infections.
Prepare the child for a platelet transfusion.
Monitor the child for indications of active bleeding.
Initiate a low-protein diet for the child.
The Correct Answer is A
A. Screen the child's visitors for active infections. Neutropenia places the child at high risk for infection due to a severely weakened immune system. Screening visitors for signs of illness is essential to minimize exposure to infectious agents.
B. Prepare the child for a platelet transfusion. Platelet transfusions are used to treat thrombocytopenia, not neutropenia. While leukemia may cause both conditions, neutropenia specifically increases infection risk, not bleeding risk.
C. Monitor the child for indications of active bleeding. While bleeding is a concern in leukemia, it is more directly linked to low platelet levels. The priority intervention for neutropenia is infection prevention, not bleeding control.
D. Initiate a low-protein diet for the child. A low-protein diet is not appropriate for a child with leukemia. These children need adequate protein for healing, immune support, and maintaining strength during treatment.
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Related Questions
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}
Explanation
- Prolonged rupture of membranes: Rupture of membranes lasting longer than 18 hours increases the risk of ascending bacterial infection, leading to conditions such as endometritis. This is a known risk factor for postpartum infection, especially following cesarean delivery.
- Polyhydramnios: An excessive amount of amniotic fluid overdistends the uterus, which can impair its ability to contract effectively postpartum, making uterine atony more likely. Atony can lead to increased bleeding or retained lochia.
- Prenatal anemia: While not directly causing infection, anemia impairs immune function, increasing a person's susceptibility to postpartum infections. It can also worsen recovery from infections or surgical wounds.
- High parity: Multiple prior pregnancies stretch the uterus over time, reducing myometrial tone, which predisposes to uterine atony. This makes it harder for the uterus to contract adequately after delivery, increasing the risk for hemorrhage or subinvolution.
Correct Answer is A
Explanation
A. "Rise slowly when getting out of bed." Furosemide can lead to significant fluid and electrolyte loss, causing orthostatic hypotension. Clients may experience dizziness or lightheadedness when changing positions. Rising slowly helps prevent falls and promotes safety.
B. “Taking furosemide can cause you to be overhydrated." Furosemide is a potent diuretic that promotes fluid excretion, not retention. The risk of dehydration and electrolyte imbalance is much higher than overhydration. Monitoring intake and output is essential.
C. "Eat foods that are high in sodium." High sodium intake increases fluid retention, which can worsen heart failure symptoms. Furosemide is often prescribed to manage fluid overload, and sodium-rich foods would counteract its effects. A low-sodium diet is recommended.
D. “Taking furosemide can cause your potassium levels to be high." Furosemide increases the excretion of potassium through the kidneys, often leading to hypokalemia. Low potassium levels can result in muscle weakness or cardiac arrhythmias.
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