A nurse is preparing to collect data from a school-age child.
Which of the following areas should the nurse palpate to find the radial pulse?

Choice C rationale

Hives on the child's neck is the priority finding because it can indicate an allergic reaction, which may progress to anaphylaxis. Anaphylaxis is a severe, life-threatening allergic reaction that requires immediate intervention. Hives are often the first sign of an allergic reaction and can quickly escalate to airway obstruction, difficulty breathing, and cardiovascular collapse. Early identification and treatment of an allergic reaction can prevent these severe complications. The nurse should be prepared to administer emergency medications, such as epinephrine, and provide respiratory support if needed.

Choice A rationale

Redness at the injection site is a common and expected local reaction following immunization. It typically resolves on its own without intervention. While it may cause some discomfort, it does not pose an immediate threat to the child's health and is not a priority over signs of a potential allergic reaction.

Choice B rationale

A temperature of 37.7°C (99.9°F) is a mild fever and a common response to immunizations as the body mounts an immune response. It is not usually cause for concern and can be managed with antipyretics if necessary. This mild fever does not indicate an urgent condition compared to the signs of an allergic reaction.

Choice D rationale

Prolonged crying can be a sign of discomfort or pain following an immunization but is not necessarily indicative of a severe reaction. It is important to assess the child's overall condition and provide comfort measures. However, it does not take precedence over signs of an allergic reaction, which require immediate attention.

Choice A rationale

Placing the child supine with legs flexed outward into a frog-like position is appropriate for certain procedures but not for bone marrow aspiration. This position is more commonly used for procedures involving the genital or lower abdominal areas and does not provide optimal access to the posterior iliac crest.

Choice B rationale

Positioning the child sitting with their buttocks at the edge of the table is not suitable for bone marrow aspiration. This position may cause discomfort and instability for the child and does not expose the posterior iliac crest, the typical site for bone marrow collection in children.

Choice C rationale

Positioning the child side-lying to expose the vertebrae is used for lumbar punctures or procedures involving the spinal column. This position does not provide access to the posterior iliac crest, which is the preferred site for bone marrow aspiration in children. It is important to use the correct position to ensure a successful procedure.

Choice D rationale

Placing the child in prone position to expose the posterior iliac crest is the correct method for bone marrow aspiration. This position allows the healthcare provider to easily access the iliac crest, a common site for obtaining bone marrow samples. Ensuring the child is in the correct position helps minimize discomfort and facilitates the procedure.