You are reviewing the Complete Blood Count for a 3-year-old who has been diagnosed with idiopathic thrombocytopenia purpura.
Which information should you report immediately to the health care provider?
Increased eosinophil level.
Hemoglobin level of 6.1 grams per deciliter.
Platelet count of 40,000 per cubic millimeter.
Elevated reticulocyte count.
The Correct Answer is B
Choice A rationale
An increased eosinophil level, or eosinophilia, often indicates an allergic response or a parasitic infection, which is a significant finding but not immediately life-threatening. While needing further investigation, it does not represent an acute physiological crisis that demands emergent reporting, unlike critical oxygen-carrying capacity impairment. The normal range for eosinophils is typically 1 to 4 percent of the total white blood cell count.
Choice B rationale
A hemoglobin level of 6.1 grams per deciliter is severely low, far below the normal range for a child (approximately 11 to 14 g/dL), indicating significant anemia. This critically impairs the blood's oxygen-carrying capacity, risking tissue hypoxia, cardiac strain, and potential shock, requiring immediate intervention such as a blood transfusion.
Choice C rationale
A platelet count of 40,000 per cubic millimeter is low, consistent with the diagnosis of idiopathic thrombocytopenia purpura, which is defined by a count below 150,000. While this count increases the risk of bleeding and requires close monitoring, it is an expected part of the diagnosis and is not immediately as life-threatening as severe anemia unless active major bleeding is occurring.
Choice D rationale
An elevated reticulocyte count, or reticulocytosis, indicates increased production of immature red blood cells by the bone marrow, typically a compensatory response to anemia or hemorrhage. This finding suggests the body is actively trying to correct the low hemoglobin, which is a positive sign and not an immediate emergency requiring urgent reporting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
A temperature of 97.3 degrees F (36.3 degrees C) is considered mildly hypothermic for a neonate, as the normal axillary temperature range is typically 97.7 to 99.5 degrees F (36.5 to 37.5 degrees C). This slightly low temperature indicates inadequate thermoregulation or heat loss, even while under a radiant warmer, and requires intervention.
Choice B rationale
Preterm neonates, especially those at 32 weeks' gestation, have an incomplete development and limited supply of brown adipose tissue, which is the primary non-shivering thermogenesis mechanism in newborns. This lack of available brown fat reserves significantly impairs their ability to generate heat metabolically, making them highly susceptible to cold stress and hypothermia.
Choice C rationale
While conduction heat loss is a factor where heat transfers from the infant's body to a cooler surface, it is minimized by the use of a radiant warmer and proper bedding. The primary cause of the preterm infant's hypothermia is their physiological immaturity in heat production, rather than a single mode of heat loss.
Choice D rationale
Axillary temperatures are considered a valid and safe method for assessing temperature in both term and preterm neonates, providing a reliable measure of core body temperature. Rectal temperatures, while sometimes used, carry a small risk of perforation and are not routinely preferred for initial or frequent checks in this population.
Correct Answer is D
Explanation
Choice A rationale
Incessant, high-pitched crying is a hallmark symptom of central nervous system (CNS) hyperirritability observed in infants with Neonatal Abstinence Syndrome (NAS). This persistent distress is due to the lack of the depressant drug effects in the newborn's system, leading to uncoordinated and exaggerated responses to stimuli. The infant's state is often difficult to soothe, contributing to parental stress and feeding difficulties.
Choice B rationale
Pharmacological treatment for significant opioid-related withdrawal (NAS) often involves the use of opioids, such as morphine or methadone, to manage severe symptoms, allowing the infant to be weaned gradually from the dependence. For withdrawal from other substances, such as selective serotonin reuptake inhibitors, supportive care is primarily used, while for alcohol, benzodiazepines might be used, reflecting substance-specific treatment strategies.
Choice C rationale
Clustering care minimizes external stimulation and provides periods of uninterrupted rest, which is essential for managing the CNS hyperirritability common in NAS. Furthermore, feeding difficulties are frequent due to poor suck-swallow coordination, tremors, and gastric issues, so dedicated, supportive feeding assistance is a crucial component of the nursing care plan.
Choice D rationale
Urine and meconium drug screening is absolutely indicated and is crucial for identifying the specific substances the infant was exposed to prenatally. This information is vital for diagnosis, determining the severity of withdrawal (using tools like the Finnegan score), guiding the appropriate pharmacological and non-pharmacological treatment plan, and initiating social services involvement. —.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.