A nurse on an oncology unit is assessing a child who has a brain tumor. Which of the following findings should the nurse expect?

Choice A reason: Bleeding precaution is indicated for a child who has leukemia and a critically low platelet count, as it reduces the risk of hemorrhage and injury. The nurse should monitor the child for signs of bleeding, such as petechiae, ecchymosis, epistaxis, hematuria, and melena. The nurse should also avoid invasive procedures, use soft-bristled toothbrushes, apply pressure to venipuncture sites, and administer platelet transfusions as prescribed.

Choice B reason: Droplet precaution is not indicated for a child who has leukemia and a critically low platelet count, unless the child has a respiratory infection that is transmitted by droplets. Droplet precaution involves wearing a mask when within 3 feet of the child, and placing the child in a private room or with a roommate who has the same infection.

Choice C reason: Neutropenic precaution is indicated for a child who has leukemia and a critically low neutrophil count, as it reduces the risk of infection and sepsis. Neutropenic precaution involves placing the child in a private room with positive pressure airflow, wearing gloves, gown, and mask when entering the room, and restricting visitors who are ill or immunocompromised.

Choice D reason: Contact precaution is not indicated for a child who has leukemia and a critically low platelet count, unless the child has a skin or wound infection that is transmitted by direct or indirect contact. Contact precaution involves wearing gloves and gown when entering the room, and placing the child in a private room or with a roommate who has the same infection.

Choice A reason: Increased appetite is not a common finding in children with brain tumors. On the contrary, they may have decreased appetite, nausea, vomiting, or weight loss due to increased intracranial pressure or tumor location.

Choice B reason: Negative Babinski reflex is a normal finding in children over 2 years old and adults. It means that the toes curl downward when the sole of the foot is stimulated. A positive Babinski reflex, which means that the big toe moves upward and the other toes fan outward, is a sign of damage to the corticospinal tract, which may be caused by a brain tumor.

Choice C reason: Tachycardia, or rapid heart rate, is not a specific finding for brain tumors. It may be caused by many factors, such as fever, pain, anxiety, dehydration, or medications. However, some brain tumors may affect the autonomic nervous system, which regulates the heart rate, and cause bradycardia, or slow heart rate.

Choice D reason: Hyporeflexia, or diminished reflexes, is a possible finding in children with brain tumors. It indicates a dysfunction of the lower motor neurons, which may be affected by the tumor or the increased intracranial pressure. Hyporeflexia may manifest as weakness, numbness, or decreased muscle tone in the affected limbs.