Chapter 27
The nurse, caring for a child receiving chemotherapy, notes that the childs abdomen is firm and slightly distended. There is no record of a bowel movement for the last 2 days. What do these assessment findings suggest?
peripheral neuroapthy
The most recent blood count for a child who received chemotherapy last week shows neutropenia. What is the priority nursing diagnosis for this child?
risk for infection
A school-aged child is living with a chronic disease process. How would the nurse anticipate chronic illness will effect growth and development?
Impaired sense of belonging Decreased feelings of independence
A child has just been diagnosed with acute lymphoblastic leukemia. What is the result of an overproduction of immature white blood cells in the bone marrow?
Increased susceptibility to infection
What should the nurse closely assess in a child receiving a transfusion?
fever
On admission, a child with leukemia has widespread purpura and a platelet count of 19,000/mm3. What is the priority nursing intervention?
Assessing neurological status
What is the result of a deficiency of factor IX?
Christmas Disease
The child receiving a transfusion complains of back pain and itching. What is the best initial action by the nurse?
Clamp off blood and keep line open with normal saline.
What would the nurse include in a teaching plan about mouth care of a child receiving chemotherapy?
Clean teeth with a soft toothbrush.
A newly married couple is seeking genetic counseling because they are both carriers of the sickle cell trait. How can the nurse best explain the childrens risk of inheriting this disease
Each child has a one in four chance of having the disease and a two in four chance of being a carrier.
How has synthetic recombinant antihemophilic factor improved the management of hemophilia?
Eliminates the need for frequent transfusions Can be administered by family at home Reduces cost of care of the hemophiliac Reduces risk of HIV and hepatitis A and B transmission
What important focus of nursing care for the dying child and the family should the nurse implement?
Families should be made aware that hearing is the last sense to stop functioning before death.
Which statement by a mother may indicate a cause for her 9-month-olds iron deficiency anemia?
Formula is so expensive. We switched to regular milk right away.
What are the classic symptoms of thalassemia major (Cooleys anemia)
Hepatomegaly Jaundice Protruding teeth Pathological fractures
An adolescent is diagnosed with Hodgkins disease. Lymph nodes on both sides of her diaphragm have been found to be involved, including cervical and inguinal nodes. Which disease stage is this?
III
A 2-year-old child has been diagnosed with hemophilia A. What information should the nurse include in a teaching plan about home care?
If bleeding occurs, apply pressure, ice, elevate, and rest the extremity.
Which statement made by a parent indicates an understanding of health maintenance of a child with sickle cell disease?
It is important for my child to drink plenty of fluids.
The nurse is presenting information on the congentital disorder of hemophilia A. What fact will the nurse include?
It is transmitted by symptom-free females.
The nurse is caring for a child with a low platelet count. What skin assessments would alert the nurse to bleeding?
Petichiae Purpura Ecchymosis Hematoma
The nurse notes that a 4-year-old childs gums bleed easily and he has bruising and petechiae on his extremities. Which lab value is consistent with these symptoms?
Platelet count of 25,000/mm3
Why would the nurse urge the family of a dying 12-year-old boy to include his 8-year-old sister in care?
She will feel less neglected by the parents. She can make amends for past hostilities to her brother. She can express her feelings through care. She can experience being supportive of her parents and brother.
The nurse finds an adolescent with Hodgkins disease crying. The adolescent says, I am so scared. What is the most appropriate nursing response to this comment?
Tell me whats got you scared.
The nurse is dealing with a preschool-age child with a life-threatening illness. What should the nurse remember the childs concept of death is at this age?
That a person becomes alive again soon after death
The family of a child receiving chemotherapy for leukemia should be taught to focus on which aspect(s) of the childs care?
Using a support group Stimulating appetite Maintaining adequate hydration Reporting exposure to infectious diseases
The nurse explains that the COPP medical regimen for the treatment of Hodgkins disease uses a combination of which drugs?
Vincristine Cyclophosphamide Prednisone Procarbazine hydrochloride
A 6-year-old with leukemia asks, Who will take care of me in heaven? What is the best response by the nurse?
Who do you think will take care of you?
What should be included in the nursing care of a 12-year-old child receiving radiation therapy for Hodgkins disease?
application of sunblock Appetite stimulation Conservation of energy Provision for expressions of anger
What will the nurse teach the parents of a child with a low platelet count to avoid?
aspirin
The nurse is teaching the parents of a young child with iron deficiency anemia about nutrition. What food would the nurse emphasize as being a rich source of iron?
cream of wheat
A child is diagnosed with iron deficiency anemia. What will the nurse explain can occur if this disorder goes untreated?
heart failure
A child with thalassemia major receives blood transfusions frequently. What is a complication of repeated blood transfusions?
hemosiderosis
A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with severe abdominal pain. Which type of crisis is the child most likely experiencing?
vaso-occulsive
What will the nurse administer with ferrous sulfate drops when providing them to a child on the pediatric unit?
with orange juice
