The nurse analyzes the laboratory values of a pediatric client with leukemia who is receiving chemotherapy. The nurse notes the following lab values: platelets 19,500/mcl (nl. 140,000-400,000/mcL), hemoglobin 11 g/dL (nl. 12-16 g/dL), white blood cell count 9,800/mcl (nl. 5,000-10,000/mcL). Based on these findings, which intervention should the nurse prioritize in the plan of care?
Monitoring closely for signs of infection.
Transfusing packed red blood cells.
Administering intravenous immunoglobulins.
Initiating bleeding precautions.
The Correct Answer is D
A. Monitoring for infection is important, but the white blood cell count is within normal limits, so it is not the immediate priority.
B. Although the hemoglobin is slightly low, it is not critically low, so transfusion of packed red blood cells is not immediately necessary.
C. Intravenous immunoglobulins are not indicated based on the current lab values.
D. The platelet count is critically low, placing the client at high risk for bleeding. Initiating bleeding precautions is the priority to prevent hemorrhage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Bronchiolitis usually presents with wheezing and difficulty breathing, not drooling or inability to cough.
B. Asthma typically presents with wheezing, shortness of breath, and coughing, but not with drooling or an inability to cough.
C. Nasopharyngitis, or the common cold, usually causes symptoms like runny nose, cough, and sore throat, but not drooling or agitation.
D. Bacterial epiglottitis is a life-threatening condition characterized by drooling, agitation, inability to cough, and potential airway obstruction. The child often appears anxious and sits leaning forward in a "tripod" position.
Correct Answer is C
Explanation
A. Decreased urine specific gravity is not typical; rather, increased specific gravity may be noted due to concentrated urine.
B. Hypotension is not usually associated with acute glomerulonephritis; hypertension is more common due to fluid retention and renal impairment.
C. A positive antistreptolysin O titer indicates a recent streptococcal infection, which is often the cause of post-streptococcal glomerulonephritis.
D. Elevated blood urea nitrogen (BUN) and creatinine levels are expected due to impaired kidney function, not low levels.
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