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A pediatric nurse is assisting with the care of a school-age child who has leukemia.

Exhibits
Which of the following data collection findings should the nurse report to the provider? Select the 5 findings that should be reported to the provider.

Blood pressure

Skin assessment

Breath sounds

Oxygen saturation

WBC count

Retractions

Respiratory rate

Hemoglobin

Answer and Explanation

Correct Answer : B,C,D,F,G

A. Blood pressure: The blood pressure is within normal limits and does not indicate an acute issue in this context.

B. Skin assessment: The presence of pallor and bruising indicates potential anemia and thrombocytopenia, common in leukemia patients but concerning signs that need to be monitored.

C. Breath sounds: Rhonchi in the upper lobes suggest respiratory congestion or infection, which is dangerous in an immunocompromised child.

D. Oxygen saturation: A drop in oxygen saturation to 90% indicates impaired oxygenation, which could signify respiratory distress or worsening infection.

E. WBC count: Although WBC count is within the low-normal range, it does not independently indicate an immediate change in the child’s condition.

F. Retractions: Subcostal retractions indicate respiratory distress, which is critical to report as it could escalate quickly in a child.

G. Respiratory rate: The increased respiratory rate (from 22 to 30/min) reflects respiratory distress and may worsen if the infection progresses.

H. Hemoglobin: While low, the hemoglobin is not acutely life-threatening in this case and would not necessarily prompt urgent intervention without other symptoms.

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Correct Answer is B

Explanation

A. Myxedema: Myxedema is associated with hypothyroidism, not multiple myeloma.

B. Pathologic fracture: Advanced multiple myeloma causes bone demineralization and osteolytic lesions, making bones fragile and increasing the risk for pathologic fractures.

C. Retinopathy: Retinopathy is commonly associated with diabetes or hypertension, not with multiple myeloma.

D. Gastrointestinal bleeding: Gastrointestinal bleeding is not a typical complication of multiple myeloma.

A. "My son will have to grow a beard." B. "My son will have to avoid contact sports." C. "My son will have to avoid fresh foods such as fruit in his diet." D. "My son will always have to live near a major hospital."

Correct Answer is B

Explanation

A. "My son will have to grow a beard." Growing a beard is irrelevant to managing hemophilia and preventing bleeding.

B. "My son will have to avoid contact sports." Avoiding contact sports is essential for children with hemophilia to reduce the risk of trauma and bleeding episodes due to their clotting factor deficiency.

C. "My son will have to avoid fresh foods such as fruit in his diet." Fresh foods like fruits do not pose a bleeding risk for hemophilia; dietary restrictions are generally unnecessary in managing this condition.

D. "My son will always have to live near a major hospital."While proximity to a healthcare facility can be helpful in emergencies, this is not a requirement for managing hemophilia, nor does it directly prevent bleeding episodes.

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A pediatric nurse is assisting with the care of a school-age child who has leukemia. Exhibits Which of the following data collection findings should the nurse report to the provider? Select the 5 findings that should be reported to the provider.

Nursing Test Bank

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A nurse is assisting in planning care for a client who has advanced multiple myeloma. When planning care the nurse should recognize that the client is at risk for which of the following complications?

Correct Answer is B

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Correct Answer is B

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A pediatric nurse is assisting with the care of a school-age child who has leukemia.

Exhibits
Which of the following data collection findings should the nurse report to the provider? Select the 5 findings that should be reported to the provider.