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Peds- Hematologic Cancers Sherpath Latest Update
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Peds- Hematologic Cancers SherpathLatest Update
A six-year-old child with leukemia presents with altered level of consciousness (LOC)
and sluggish pupils but no cardiac compromise after falling from a bike. The nurse notes
a platelet count of 10,000, WBC of four, and hemoglobin of seven. After the patient's
airway is stabilized, which priority order should the nurse anticipate?
Obtain a head CT
Assess serum glucose
Administer IV fluid bolus
Administer pain medication - Answer Obtain a head CT
The nurse should first obtain a head CT on a patient with thrombocytopenia and altered
LOC after a head injury to evaluate for cerebral hemorrhage.
The nurse is caring for a four-year-old child with leukemia who is receiving
chemotherapy. The parent reports that the child has abdominal pain, nausea, and
vomiting. Upon exam, the nurse notes poor skin turgor, pallor, dry mucus membranes,
and poor appetite. Which action should the nurse take first?
Administer pain medicine
Assess hourly urine output
Administer oral antiemetic
Administer normal saline IV bolus - Answer Administer normal saline IV bolus
A child with leukemia is at risk for dehydration and fluid and nutrition imbalance. Thus,
administering IV bolus of normal saline is a priority nursing intervention to treat signs of
dehydration.
A child diagnosed with leukemia reports nausea, vomiting, and anorexia related to
chemotherapy treatment. The nurse notes a hemoglobin count of 10, WBC count of 8,
platelet count of 103,000, and an albumin level of 2.1. Which prescription would the
nurse anticipate?
Decrease dietary protein
Administer PO allopurinol
Administer platelet transfusion
Administer total parenteral nutrition - Answer Administer total parenteral nutrition
, An albumin level of 2.1 indicates malnutrition. The nurse would administer total
parenteral nutrition via a central line to improve the child's nutritional status.
The nurse is educating the parents of a child with leukemia about necessary homecare.
During the teaching session, the mother states, "We plan to let him return to baseball
practice next week." Which information is most important for the nurse to include in the
response?
Avoid physically exhausting activities.
Apply ample amounts of sunscreen on child's skin while outside.
Assess the child's mucus membranes for signs of dehydration frequently while playing.
Notify the health care provider immediately if the child has shortness of breath while
playing. - Answer Avoid physically exhausting activities.
Providing information about activities to be avoided, such as baseball, is the most
important teaching that the nurse should provide the mother because patients with
leukemia are often thrombocytopenic and neutropenic, and engaging in physically
exhausting activities can trigger bleeding, injury, and infection.
A two-year-old child diagnosed with Hodgkin Lymphoma presents with enlarged neck
lymph nodes, and an x-ray reveals widening of the mediastinum. Which action should
the nurse take first?
Prepare for surgical excision
Auscultate for bowel sounds
Assess the child's airway for patency
Educate parents or caregiver on chemotherapy - Answer Assess the child's airway for
patency
The nurse should assess the airway patency of a child with cervical lymphadenopathy
and mediastinal disease from Hodgkin lymphoma, because swelling of cervical lymph
nodes and mediastinal disease can cause airway obstruction.
The nurse is caring for a 16-year-old child diagnosed with Hodgkin Lymphoma who
reports shortness of breath, and chest pain. The nurse notes hoarseness of patient's
voice when speaking. Which prescription would the nurse take first?
Obtain sputum culture
Administer pain medication
Administer albuterol nebulizer
Obtain an emergency chest radiograph - Answer Obtain an emergency chest
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