Nursing care of a child who is immunosuppressed due to leukemia or chemotherapeutic agents should include:

(choose one best answer)

Choice A reason: This choice is incorrect because 1 cup of cooked rice provides more than 1 oz of grains. According to the U.S. Department of Agriculture (USDA), one-ounce equivalent of grains equals one slice of bread, one cup of ready-to-eat cereal, or half a cup of cooked rice, pasta, or cereal. Therefore, 1 cup of cooked rice provides about 2 oz of grains.

Choice B reason: This choice is incorrect because 1/2 slice of white bread provides less than 1 oz of grains. As explained above, one-ounce equivalent of grains equals one slice of bread, so 1/2 slice of white bread provides only 0.5 oz of grains.

Choice C reason: This choice is correct because 1 cup of ready-to-eat cereal flakes provides exactly 1 oz of grains. As explained above, the one-ounce equivalent of grains equals one cup of ready-to-eat cereal, so 1 cup of ready-to-eat cereal flakes provides 1 oz of grains.

Choice D reason: This choice is incorrect because 1/2 white flour tortilla provides less than 1 oz of grains. According to the USDA, one-ounce equivalent of grains equals one small tortilla (6 inches in diameter), so 1/2 white flour tortilla provides only about 0.4 oz of grains.

Choice A: Performing range of motion on the infant's hips is not appropriate for an infant who has myelomeningocele, which is a type of spina bifida that causes a sac-like protrusion of the spinal cord and nerves through an opening in the spine. Performing range of motion on the infant's hips can cause nerve damage or pain in the lower extremities, which may already be affected by the condition.

Choice B: Taking an axillary temperature is appropriate for an infant who has myelomeningocele, as it is a non-invasive and accurate method of measuring body temperature. An axillary temperature is taken by placing a thermometer under the armpit and holding the arm close to the body. Taking an axillary temperature can help monitor for signs of infection or inflammation, which are common complications of myelomeningocele.

Choice C: Placing the infant in a side-lying position is not appropriate for an infant who has myelomeningocele, as it can cause pressure or friction on the sac and increase the risk of rupture or infection. The correct position for an infant with myelomeningocele is prone with hips slightly flexed and legs abducted. This position can prevent trauma and promote drainage from the sac.

Choice D: Maintaining a dry dressing over the sac is not appropriate for an infant who has myelomeningocele, as it can cause irritation or infection of the sac and surrounding skin. The correct dressing for an infant with myelomeningocele is moist and sterile with saline or antibiotic solution. This dressing can prevent drying and cracking of the sac and reduce bacterial growth.