A nurse is reviewing the complete blood count results for a 4-year-old child who is receiving treatment for acute lymphoblastic leukemia. Which of the following findings should indicate to the nurse that the treatment is having a therapeutic effect?
Hemoglobin 6.8 g/dL (9.5 to 14 g/dL)
Platelet count 98,000/mm3 (150,000 to 400,000/mm3)
RBC count 5/mm3 (4 to 5.5/mm3)
WBC count 15,000/mm3 (5,000 to 10,000/mm3)
The Correct Answer is C
A. A low hemoglobin level indicates anemia, which is common in leukemia but does not necessarily indicate treatment effectiveness.
B. A low platelet count is a sign of bone marrow suppression, which is a common side effect of chemotherapy for leukemia.
C. A normal RBC count indicates that the child's bone marrow is producing enough red blood cells to carry oxygen throughout the body.
D. Elevated WBC count is typical in leukemia and does not necessarily indicate treatment effectiveness.
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Related Questions
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"E"}
Explanation
A. While acute glomerulonephritis can occur following certain infections such as streptococcal infections, it is less commonly associated with fever and lethargy compared to pyelonephritis.
B. Pyelonephritis is a bacterial infection of the kidneys commonly associated with fever and lethargy, especially in young children. The fever and lethargy reported by the parent, along with the urine sample obtained, suggest a concern for pyelonephritis.
C. Polycystic kidney disease typically presents later in life and is not typically associated with acute febrile illness in a 1-year-old toddler.
D. Renal scarring can occur as a complication of untreated or recurrent urinary tract infections (UTIs), particularly pyelonephritis. The presence of fever and lethargy in the child, along with the history of decreased appetite, raises concerns for a urinary tract infection that could lead to renal scarring if left untreated.
E. Nephrotic syndrome typically presents with edema, proteinuria, hypoalbuminemia, and hyperlipidemia, rather than the symptoms described in the scenario.
Correct Answer is D
Explanation
A. While assessing pain level is important, ensuring adequate perfusion and circulation takes precedence.
B. Rechecking the child's temperature may be necessary but is not as immediately critical as assessing pedal pulses.
C. Determining the child's sedation level is important for monitoring postoperative status but is not the priority at this time.
D. Assessing the child's pedal pulses is crucial following a motor-vehicle crash and surgical procedures involving the lower extremities. It helps to evaluate the perfusion and circulation to the extremities, especially after a leg open reduction and fixation surgery.
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