A nurse on a pediatric unit is reviewing the laboratory results for a group of clients. Which of the following results should the nurse identify as the priority?
An adolescent who has iron-deficiency anemia and an Hgb level of 11 g/dL (10 to 15.5 g/dL)
A school-age child who has diabetes mellitus and an HbA1c of 8% (less than 7%)
A toddler who has moderate dehydration and an RBC count of 5.6/mm3 (4 to 5.5/mm3)
A preschooler who has cystic fibrosis-related diabetes and a WBC count of 15,000/mm3 (5,000 to 10,000/mm3)
The Correct Answer is D
A. An adolescent who has iron-deficiency anemia and an Hgb level of 11 g/dL (10 to 15.5 g/dL):
An Hgb level of 11 g/dL in an adolescent with iron-deficiency anemia is within the expected range for someone with this condition. While iron-deficiency anemia requires management, it is not an urgent or critical condition requiring immediate intervention.
B. A school-age child who has diabetes mellitus and an HbA1c of 8% (less than 7%):
An HbA1c level of 8% in a child with diabetes mellitus indicates poor glycemic control and may increase the risk of long-term complications. While it requires attention and adjustment of the treatment plan, it is not an urgent or critical condition requiring immediate intervention.
C. A toddler who has moderate dehydration and an RBC count of 5.6/mm3 (4 to 5.5/mm3):
Moderate dehydration in a toddler is a concerning finding that requires prompt intervention to restore fluid balance and prevent complications. However, the RBC count of 5.6/mm3 is within the normal range and does not indicate an urgent or critical condition.
D. A preschooler who has cystic fibrosis-related diabetes and a WBC count of 15,000/mm3 (5,000 to 10,000/mm3):
A WBC count of 15,000/mm3 in a preschooler with cystic fibrosis-related diabetes may indicate an infection or inflammatory process. Elevated WBC count warrants further assessment and possible intervention to identify and treat the underlying cause, making this the priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Decreased calories:
During illness, it's important to ensure adequate calorie intake to meet the body's increased energy demands for fighting off infection. Decreasing calories is not appropriate and can lead to hypoglycemia in a child with diabetes mellitus.
B. Increased fluids:
This is the correct option. During illness, the body's fluid requirements increase due to fever, sweating, and increased urination. Providing increased fluids helps prevent dehydration, which can exacerbate hyperglycemia. Parents should encourage the child to drink plenty of water or other sugar-free fluids to stay hydrated.
C. Blood glucose monitoring every 8 hr:
During illness, blood glucose levels may fluctuate more than usual due to changes in food intake, activity level, and the body's response to stress. Therefore, more frequent blood glucose monitoring is necessary, typically every 2-4 hours or as directed by the healthcare provider, rather than every 8 hours.
D. Urine testing for leukocytes:
Urine testing for leukocytes is not directly related to managing diabetes mellitus during illness. It may be done to assess for urinary tract infections, which can occur more frequently in individuals with diabetes, but it is not a routine part of diabetes management during illness.
Correct Answer is D
Explanation
A. FACES: The FACES pain scale is a visual analog scale commonly used with older children who can point to or select a facial expression that best represents their pain level. It may not be suitable for infants who may not have the cognitive or motor skills to use the scale effectively.
B. COMFORT: The COMFORT scale assesses pain in infants and young children based on behaviors such as crying, facial expressions, and body movements. It evaluates parameters such as alertness, calmness, respiratory response, physical movement, and muscle tone. The COMFORT scale is suitable for assessing pain in infants and young children, including those who are postoperative.
C. CRIES: The CRIES scale is a neonatal pain assessment tool that evaluates crying, oxygen saturation, vital signs, expression, and sleeplessness. While it is designed for newborns and infants up to 6 months of age, it may not be as appropriate for a 12-month-old infant who is postoperative and beyond the neonatal period.
D. FLACC: The FLACC scale assesses pain in infants and young children based on five behavioral categories: facial expression, leg movement, activity level, cry, and consolability. It is commonly used in pediatric settings and is suitable for assessing pain in infants who are postoperative.
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