Nursing Care of the Child With an Alteration in Cellular Regulation/Hematologic or Neoplastic Disorder

The nurse is caring for a 14-year-old client scheduled for magnetic resonance imaging (MRI). The nurse explains the test to the child and family. Which information would be most appropriate to include in the explanation? a. "The MRI uses radio waves and magnets to produce a computerized image of the body." b. "The MRI is a nuclear scanning test to rule out cancer involving the bones or determine extent of bone involvement." c. "The MRI uses sound waves to create images the visualize body structures and locate masses." d. "The MRI uses radiation to examine soft tissue and bony structure of the body."

a. "The MRI uses radio waves and magnets to produce a computerized image of the body."

The nurse is caring for a 6-year-old boy with an abdominal neuroblastoma prior to having a magnetic resonance imaging (MRI) scan without contrast done. Which intervention would the nurse expect to perform? a. Administering a sedative as ordered to keep the child still b. Encouraging fluid intake to increase radiouclide uptake c. Advising the physician that the child is allergic to shellfish d. Applying EMLA to the injection site prior to inserting the iV

a. Administering a sedative as ordered to keep the child still

An 8-month-old girl appears pale, irritable, and anorexic. On blood testing, the red blood cells are hypochromic and microcytic. The hemoglobin level is less than 5 g/100 mL, and the serum iron level is high. Which symptom should the nurse most expect as a result of excessive iron deposits? a. An enlarged spleen b. An enlarged heart c. Enlarged lymph nodes d. An enlarged thyroid gland

a. An enlarged spleen

The pediatric nurse reviews the radiographs of a child and observes that there are lesions on the bone. The nurse interprets this finding as suggesting which condition? a. Ewing sarcoma b. Hodgkin disease c. non-Hodgkin lymphoma d. Neuroblastoma

a. Ewing sarcoma

The nurse is caring for a client with terminal cancer who is experiencing dyspnea and increasing levels of pain. What would be the priority for pain management with this child? a. Preventing and alleviating pain b. Monitoring the child's vital signs frequently c. Following the health care provider's rigid guidelines regarding dosages d. Preventing addiction to the opioid medications

a. Preventing and alleviating pain

A child with acute lymphoblastic leukemia (ALL) is receiving methotrexate for therapy. Which nursing diagnosis would best apply during therapy? a. Risk for impaired skin integrity related to oral ulcerations associated with chemotherapy b. Risk for impaired mobility related to depressant effects of methotrexate c. Excess fluid volume related to effect of methotrexate on aldosterone secretion d. Risk for self-directed violence related to effect of methotrexate on central nervous system

a. Risk for impaired skin integrity related to oral ulcerations associated with chemotherapy

The nurse will select which meal as the best choice for a child with iron-deficiency anemia? a. cheeseburger, broccoli, and fresh strawberries b. chicken breast, french fries, and sweetened tea c. peanut butter sandwich, cheese stick, and applesauce d. two slices of pepperoni pizza and a glass of skim milk

a. cheeseburger, broccoli, and fresh strawberries

The nurse is administering meperidine as ordered for pain management for a 10-year-old boy in sickle cell crisis. The nurse would be alert for: a. seizures b. behavioral addiction c. priapism d. leg ulcers

a. seizures

Parents tell the nurse who is admitting their infant for a well-child exam that they recently saw a "white glow" in their child's left pupil. What is the nurse's best response? a. "Most parents mention a red color." b. "I will report this to the pediatrician." c. "Has your baby been rubbing either eye." d. "A plugged tear duct would not be unusual."

b. "I will report this to the pediatrician."

A couple is expecting a child. The fetus undergoes genetic testing and the couple discover the fetus has sickle cell disease. The couple ask the nurse how most commonly happens. Which statement is accurate for the nurse to provide? a. "Sickle cell disease occurs from a random genetic mutation." b. "Sickle cell disease is passed to a fetus when both parents have the gene." c. "Sickle cell disease is passed to a fetus when on of the parents has the gene." d. "Sickle cell disease can be passed to the fetus in many ways. We will know more at birth."

b. "Sickle cell disease is passed to a fetus when both parents have the gene."

The health care provider has just informed the parents of a 3-year-old that their child has leukemia. The mother begins crying and tells the nurse she does not want her baby to die. What is the nurse's best response? a. "Don't worry, the health care provider is very good a treating leukemia." b. "I don't blame you for being upset, any parent would be scared too." c. "I know this is scary, but leukemia has a high cure rate in children these days." d. "You are very lucky to have caught it so early; that makes the treatment easier."

c. "I know this is scary, but leukemia has a high cure rate in children these days."

A school-aged child is admitted to the hospital with a vaso-occlusive sickle cell crisis. Which measure in the child's care plan should be given priority? a. Beginning active ROM exercises b. Seeing that the child ingests a protein-rich diet c. Maintain fluids through an intravenous line d. Encouraging the child to take deep breaths hourly

c. Maintain fluids through an intravenous line

The nurse is caring for a child with idiopathic thrombocytopenic purpura with a platelet count of 24,000/mm3. Which health care provider prescription will the nurse question? a. Transfuse 1 unit of platelets b. Administer prednisone orally c. Provide ibuprofen as needed for pain d. Give IV immunoglobulim (IVIG)

c. Provide ibuprofen as needed for pain

A child receiving radiation therapy has a nursing diagnosis of Impaired skin integrity related to the effects of radiation therapy as manifested by erythema and dryness of the skin. Which would the nurse include in the child's plan of care? Select all that apply. a. Expose the skin to air frequently b. Soak the area in warm water for 30 40 minutes frequently c. Encourage snug-fitting clothing d. Avoid application of creams and lotions e. Use mild soap to clean the skin

a. Expose the skin to air frequently d. Avoid application of creams and lotions e. Use mild soap to clean the skin

A child with hemophilia A is scheduled for surgery. Which precautions would the nurse institute with this client? a. Handle the child gently wen transferring to a stretcher b. Caution the child not to brush the teeth before surgery c. Do not allow a dressing to be applied postoperatively d. Mark the client's chart to receive no analgesia

a. Handle the child gently wen transferring to a stretcher