A nurse is reviewing the laboratory values of an eight-month-old infant who is newly diagnosed with leukemia. Their most recent platelet count is 120,000/mm3 (200,000 to 475,000/mm3). Which of the following provider prescriptions should the nurse anticipate?

A. "Hyperextend your child's head for 5 minutes following a seizure."

This instruction is incorrect. Hyperextending the head after a seizure is not recommended and could potentially cause harm. Instead, it's important to ensure that the child's airway is clear and maintain a safe and comfortable position.

B. "Immediately following a seizure, give your child 6 ounces of water."

This instruction is not necessary unless the child specifically requests water or appears to be dehydrated. It's important to focus on ensuring the child's safety and comfort immediately after a seizure.

C. "Following a seizure, record the length and characteristics of your child's seizure."

This instruction is correct. Keeping a record of the length and characteristics of the child's seizures can provide valuable information to healthcare providers for managing the child's epilepsy and adjusting treatment as needed.

D. "Administer rectal diazepam to your child following a seizure."

This instruction may be appropriate in some cases, particularly if the child's seizures are prolonged or if they have a history of status epilepticus. However, the administration of rectal diazepam should be done according to the healthcare provider's instructions and with proper training.

E. "Call for emergency medical services if the size of your child's pupils are unequal after a seizure."

This instruction is correct. Unequal pupil size (anisocoria) after a seizure could indicate a serious underlying condition and should prompt immediate medical evaluation. It's important for the parents to be aware of this potential sign of concern and to seek prompt medical attention if it occurs.

A. Administer packed red blood cells transfusion (PRBC):

While anemia may also be a concern in leukemia, the primary issue here is thrombocytopenia, not anemia. Administering packed red blood cells transfusion would address anemia, not the low platelet count.

B. Avoid taking rectal temperatures:

This is the correct option. Taking rectal temperatures carries the risk of causing bleeding or trauma, especially in individuals with thrombocytopenia. It is essential to avoid invasive procedures or activities that may increase the risk of bleeding in a patient with a low platelet count.

C. Place child in protective environment precautions:

Protective environment precautions, also known as reverse isolation, are typically implemented for patients who are immunocompromised to protect them from exposure to infectious agents. While patients with leukemia may be immunocompromised, the low platelet count is the primary concern here, not infection risk.

D. Swab the oral cavity with viscous lidocaine:

Swabbing the oral cavity with viscous lidocaine is not indicated for thrombocytopenia. Lidocaine may have local anesthetic properties but does not address the underlying issue of low platelet count.