Essentials of Pediatric Nursing - Chapter 24
What is a well-defined risk management technique that the nurse can teach children and parents to prevent cancer? Avoid artificial colors, flavors, and fragrances in foods, cosmetics, and household items Eliminate aerosol sprays from the living area Limit sun exposure throughout childhood and adolescence Incorporate more preservative-free foods into the diet
Limit sun exposure throughout childhood and adolescence
A pediatric nurse is providing a session on risk factors for childhood cancers. Which risk factor does the nurse include in this teaching session? Select all that apply. environmental exposure, such as cigarette smoke accumulation of mutations in the cell that transform to neoplasm absence of tumor suppressor cells that allow abnormal growth viral triggers genetic markers that fail to suppress cancer genetic predisposition for certain cancers
viral triggers genetic predisposition for certain cancers genetic markers that fail to suppress cancer absence of tumor suppressor cells that allow abnormal growth accumulation of mutations in the cell that transform to neoplasm
Parents bring their daughter to the health care facility for evaluation. They report that lately the child seems rather pale and really tired. What would the nurse most likely find with further assessment if the child has acute lymphoblastic leukemia (ALL)? Select all that apply. Low-grade fever Painless cervical lymphadenopathy Bleeding from the oral mucous membranes Headache Chest pain
• Bleeding from the oral mucous membranes • Headache • Painless cervical lymphadenopathy • Low-grade fever
Parents ask why their child just diagnosed with leukemia needs a "spinal tap." Which is the bestresponse by the nurse? "A sample of cerebrospinal fluid is needed to check for possible central nervous system infection." "Checking the cerebrospinal fluid will reveal whether leukemic cells have entered the central nervous system." "The spinal tap will help relieve pressure and headache for your child." "It will help rule out a second malignancy."
"Checking the cerebrospinal fluid will reveal whether leukemic cells have entered the central nervous system."
The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is most concerning? "I brush my child's teeth once every day." "My child's stools are darker than usual." "My child takes ferrous sulfate after meals." "I mix ferrous sulfate with milk in a bottle."
"I mix ferrous sulfate with milk in a bottle."
The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with sickle cell anemia. The nurses in the group make the following statements. Which statement is most accurate regarding sickle cell anemia? "If the trait is inherited from both parents the child will have the disease." "The disease is most often seen in individuals of Asian decent." "The trait or the disease is seen in one generation and skips the next generation." "Males are much more likely to have the disease than females."
"If the trait is inherited from both parents the child will have the disease."
A mother asks the nurse why her infant who was born at 34 weeks' gestation is being prescribed ferrous sulfate. Which response by the nurse is most appropriate? "Infants with pyloric stenosis require ferrous sulfate." "Ferrous sulfate helps improve red blood cell formation." "Preterm infants are at risk for iron-deficiency anemia." "Your infant may have been having excessive diarrhea."
"Preterm infants are at risk for iron-deficiency anemia."
A nurse is conducting a class to a group of parents on sickle cell anemia. Which statement by a parent indicates teaching has been effective? "The sickle shape of red blood cells decreases oxygen to tissues." "This is a hereditary disease that is transmitted by one affected gene." "Fluid restriction is necessary to control sickle cell anemia." "Sickle cell anemia is common in people of Asian descent."
"The sickle shape of red blood cells decreases oxygen to tissues."
The nurse is caring for a child with aplastic anemia. The nurse is reviewing the child's blood work and notes the granulocyte count is about 500, platelet count is over 20,000, and the reticulocyte count is over 1%. The parents ask if these values have any significance. Which response by the nurse is appropriate? "These labs are just common labs for children with this disease." "These values will help us monitor the disease." "The doctor will discuss these findings with you when he comes to the hospital." "I'm really not allowed to discuss these findings with you."
"These values will help us monitor the disease."
A child is to receive an oral corticosteroid as part of the treatment regimen for leukemia. After teaching the child and family about this drug, the nurse determines the need for additional teaching when they state: "He might develop a rounded face from this drug." "We should administer the drug on an empty stomach." "We should check our son's urine for glucose." "We will need to gradually decrease the dosage."
"We should administer the drug on an empty stomach."
A 9-year-old child with leukemia is scheduled to undergo an allogenic hematopoietic stem cell transplant. When teaching the child and parents, what information would the nurse include? "We'll need to have a match to a donor." "The risk for rejection is much less with this type of transplant." "You'll need to have an incision in your hip area to instill the cells." "You won't need to receive the high doses of chemotherapy before the transplant."
"We'll need to have a match to a donor."
The nurse is reviewing the results of a clotting study for a healthy 6-year-old. What would the nurse document as a normal prothrombin finding? 11.0 to 13.0 seconds 16.0 to 18.0 seconds 6.0 to 9.0 seconds 21.0 to 35.0 seconds
11.0 to 13.0 seconds
The child has been diagnosed with severe iron deficiency anemia. The child requires 5 mg/kg of elemental iron per day in three equally divided doses. The child weighs 47.3 lb (21.5 kg). How many milligrams of elemental iron should the child receive with each dose? Record your answer using a whole number.
36 The dose should be calculated using weight in kilograms. 21.5 kg x 5 mg/1 kg = 107.5 mg/day. 107.5 mg/3 doses = 35.8333 mg/dose Rounded to the nearest whole number = 36 mg
A nurse is reviewing the medical records of several children who have undergone lead screening. The nurse would identify the child with which lead level as requiring no further action? 26 mcg/dL 20 mcg/dL 14 mcg/dL 8 mcg/dL
8 mcg/dL
Antiemetics are ordered to control nausea and vomiting in the child undergoing chemotherapy. How can the nurse most effectively use these medications? Use the antiemetic after it is clear that nonpharmacologic methods are not effective Start the antiemetic on a scheduled basis when the chemotherapy begins to cause nausea Provide the antiemetic as needed (PRN) when nausea and vomiting are reported Administer the antiemetic before starting chemotherapy
Administer the antiemetic before starting chemotherapy
The nurse will use a special needle to start intravenous (IV) fluids through which central venous access device? A tunneled central catheter An implanted port A peripherally inserted central catheter A multilumen catheter
An implanted port
The nurse is caring for a 10-year-old boy with hemophilia. He asks the nurse for suggestions about appropriate physical activities. Which activity would the nurse most likely recommend? Soccer Wrestling Baseball Football
Baseball
A group of nursing students are studying information about childhood cancers in preparation for a class examination. They are reviewing how childhood cancers differ from adult cancers. The group demonstrates understanding of the information when they identify what location as an unlikely site for childhood cancer? Brain Bladder Blood Kidney
Bladder
What is one advantage of an implanted port (central venous access device) that the nurse will explain to an adolescent? No special procedure is necessary for removal. Body appearance changes very little. No tunneling is needed when the port is inserted. Flushing of the device is not necessary.
Body appearance changes very little.
The nurse is admitting to an examination room a child with the diagnosis of "probable acute lymphoblastic leukemia." What will confirm this diagnosis? Complete white blood count Lethargy, bruising, and pallor History of leukemia in twin Bone marrow aspiration
Bone marrow aspiration
How can the nurse most simply describe for distressed parents a rhabdomyosarcoma that has been found in their 5-year-old? Explain that it develops in nerves outside the brain and spinal cord Call it a tumor of muscle tissue Describe it as a bone tumor Indicate that the more commonly used name is Hodgkin's disease
Call it a tumor of muscle tissue
Individuals with hemophilia B have a deficiency in factor IX, which can cause excessive blood loss. What is another name for this clotting factor? Proconvertin Antihemophilic factor Christmas factor Stuart factor
Christmas factor
A nurse is counseling parents of a 7-year-old boy with leukemia regarding the goals of the chemotherapy program for their son. What should she mention as the first goal? a) Prevention of leukemia cells from invading or growing in the CNS b) Administration of delayed intensive therapy c) Maintaining the original remission d) Complete absence of leukemia cells
Complete absence of leukemia cells
A nurse caring for an 8-year-old with a bleeding disorder documents the following nursing diagnosis: ineffective tissue perfusion related to intravascular thrombosis and hemorrhage. This diagnosis is most appropriate for a client with: von Willebrand disease Disseminated intravascular coagulation Iron-deficiency anemia Hemophilia
Disseminated intravascular coagulation
A 15-year-old client diagnosed with von Willebrand disease has reached menarche. Based on this fact, what information is most important for the nurse to convey to the client? Expect menstrual bleeding to be heavy. Bruising may occur in the perineal area. Occasional skipped periods can be expected. The duration of each period will be short.
Expect menstrual bleeding to be heavy.
A toddler who is beginning to walk has fallen and hit his head on the corner of a low table. The caregiver has been unable to stop the bleeding and brings the child to the pediatric clinic. The nurse is gathering data during the admission process and notes several bruises and swollen joints. A diagnosis of hemophilia is confirmed. This child most likely has a deficiency of which blood factor? Factor X Factor XIII Factor VIII Factor V
Factor VIII
After teaching a group of students about hemophilia, the instructor determines that the students have understood the information when they identify hemophilia A as involving a problem with: Factor IX Plasmin Platelets Factor VIII
Factor VIII
The nurse is caring for a child with leukemia. Which nursing intervention would be the highest priority for this child? Providing age-appropriate activities Following guidelines for protective isolation Encouraging the child to share feelings Grouping nursing care
Following guidelines for protective isolation
A high-school football player has been diagnosed as having osteosarcoma of the femur. The parents are angry because they told the adolescent not to play football. Which health teaching points would the nurse include in the teaching plan for the adolsecent and parents? Tumor growth is related to your dislike of milk. Football injuries do not contribute to the development of a tumor. Osteosarcoma often follows trauma, such as a football injury. You can expect some discoloration of the leg following chemotherapy.
Football injuries do not contribute to the development of a tumor.
A preschooler who received chemotherapy in the pediatric oncology outpatient department 1 week ago now has a temperature of 101.5°F (38.6°C). Which is the most appropriate response by the nurse? Instruct the parent to immediately obtain and give the antibiotic that the oncologist will order. Ask whether any family members or other close associates are ill. Tell the parent to administer acetaminophen every 4 hours until the fever dissipates. Have the parent bring the child to the pediatric oncology clinic as soon as possible.
Have the parent bring the child to the pediatric oncology clinic as soon as possible.
A nurse is preparing a 7-year-old girl for bone marrow aspiration. Which site should she prepare? Sternum Anterior tibia Iliac crest Femur
Iliac crest
A 6-year-old boy has a rash on his buttocks, posterior thighs, and the extensor surface of his arms and legs. His joints are tender and swollen. The healthcare provider diagnoses him with Henoch-Schönlein syndrome. The nurse should anticipate what laboratory results? Decreased white blood cell count Normal platelet count Decreased platelet count Elevated platelet count
Normal platelet count
The nurse is planning care for a child with idiopathic thrombocytopenic purpura. Which client education should be included? Not to pick or irritate the nose To use mainly cold water to wash To apply a soothing cream to lesions What foods are high in folic acid
Not to pick or irritate the nose
The nurse is planning care for a child with idiopathic thrombocytopenic purpura. Which client education should be included? Not to pick or irritate the nose What foods are high in folic acid To use mainly cold water to wash To apply a soothing cream to lesions
Not to pick or irritate the nose
The nurse is completing the health history of a 6-month-old infant with retinoblastoma with the child's parents. Which symptom should the nurse expect that the parents have observed? The infant's eye appears to be protruding. The infant always keeps her eyes tightly closed. One pupil appears white. The infant tugs and pulls at one ear.
One pupil appears white.
A nurse is providing care to a toddler with nephroblastoma and is being evaluated. Which nursing action would be most important? Preventing weight-bearing activities Restricting the child's visitors Ensuring that the child be allowed nothing by mouth Placing a "no abdominal palpation" sign above the child's bed Preparing the child for chemotherapy
Placing a "no abdominal palpation" sign above the child's bed
Which intervention is best to use with the 6-year-old who has developed stomatitis as a side effect of chemotherapy? Practice frequent, gentle oral hygiene Have the child freely choose desired foods and beverages Use lidocaine rinses Limit foods to cool, clear liquids
Practice frequent, gentle oral hygiene
A child is diagnosed with iron deficiency anemia. Which diagnostic test would be utilized to confirm the disease process? Serum ferritin level Serum iron level Hemoglobin electrophoresis Reticulocyte count
Serum ferritin level
The nurse is assessing a school-aged child with sickle-cell anemia. Which assessment finding is consistent with this child's diagnosis? Enlarged mandibular growth Slightly yellow sclera Increased growth of long bones Depigmented areas on the abdomen
Slightly yellow sclera
The nurse is talking with a 9-year-old child diagnosed with acute leukemia who will soon begin chemotherapy. The child expresses worry that when her hair falls out friends won't like her or want to play with her anymore. Which response by the nurse would be best?
Talk with her and her family about wearing a wig, cap, or scarf.
The nurse is teaching the parents of a 15-year-old boy who is being treated for acute myelogenous leukemia about the side effects of chemotherapy. For which symptoms should the parents seek medical care immediately? Difficulty or pain when swallowing Blisters, ulcers, or a rash appear Temperature of 101° F (38.3° C) or greater Earache, stiff neck, or sore throat
Temperature of 101° F (38.3° C) or greater
A 5-year-old child is at the pediatric clinic for a well-child visit. Which symptom alerts the health care provider that this child might have acute lymphocytic leukemia? joint pain and swelling abdominal pain, nausea, and vomiting anorexia and weight loss lethargy, bruises, and lymphadenopathy
lethargy, bruises, and lymphadenopathy
The nurse is providing care to a child and is to collect a 24-hour urine specimen for catecholamines. The nurse integrates knowledge of this testing as indicative of: neuroblastoma. Hodgkin disease. leukemia. osteosarcoma.
neuroblastoma
To prevent further sickle cell crisis, the nurse would advise the parents of a child with sickle cell anemia to: administer an iron supplement daily. encourage the child to participate in school activities, such as long-distance running. prevent the child from drinking an excess amount of fluids per day. notify a health care provider if the child develops an upper respiratory infection.
notify a health care provider if the child develops an upper respiratory infection.
A 3-year-old boy has been brought to the doctor's office with symptoms of anorexia and abdominal pain. A blood test reveals a lead level of 20 μg/100 mL. The child is prescribed an oral chelating agent. On discharge, the nurse should counsel the parents regarding: placing house plants out of reach of children removal or covering of flaking paint on the walls of the home putting child safety locks on kitchen cabinets putting medicine away where children cannot reach it
removal or covering of flaking paint on the walls of the home
Which nursing action promotes the 2020 National Health Goals related to prevention of malignancies and children? school nurse screening for vision, hearing, and scoliosis pediatric nurse monitoring lab values on child diagnosed with leukemia school nurse providing a session on sun protection for children clinic nurse plotting child's growth on a standardized growth chart
school nurse providing a session on sun protection for children
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: seizures. behavioral addiction. leg ulcers. priapism. SUBMIT ANSWER
seizures
In caring for a child with sickle cell disease, the highest priority goal is: The family will verbalize understanding of the disease crisis. The family caregivers' anxiety will be reduced. The child's skin integrity will be maintained. The child's fluid intake will improve.
The child's fluid intake will improve.
Why do nurses teach childhood cancer survivors to inform adult health care providers of their prior disease and treatments? To participate in cancer research To obtain health insurance To monitor for late effects To access community support groups
To monitor for late effects
The nurse will select which meal as the best choice for a child with iron-deficiency anemia? two slices of pepperoni pizza and a glass of skim milk chicken breast, French fries, and sweetened tea cheeseburger, broccoli, and fresh strawberries peanut butter sandwich, cheese stick, and applesauce
cheeseburger, broccoli, and fresh strawberries
The nurse is reinforcing teaching with a group of caregivers of children diagnosed with iron-deficiency anemia. One of the caregivers tells the group, "I give my child ferrous sulfate." Which statement made by the caregivers is correct regarding giving ferrous sulfate? "My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C." "I always give the ferrous sulfate with meals." "When I give my son ferrous sulfate I know he also needs potassium supplements." "We watch closely for any diarrhea since that usually happens when he takes ferrous sulfate."
"My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C."
The nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to premedicate the child for this procedure? Antineoplastic Antiemetic Antipyretic Analgesic
Antiemetic
The nurse is providing preoperative care for a 7-year-old boy with a brain tumor and his parents. Which intervention is priority? Assessing the child's level of consciousness Educating the child and parents about shunts Providing a tour of the intensive care unit Having the child talk to another child who has had this surgery
Assessing the child's level of consciousness
The child is prescribed liquid ferrous sulfate. The nurse should encourage the child to take which action immediately after each dose to best eliminate possible side effects? Drink a glass of milk Brush his or her teeth Remain in an upright position for at least 15 minutes Not eat or drink for one hour
Brush his or her teeth
A child with acute lymphoblastic leukemia (ALL) is beginning treatment with methotrexate in an attempt to eradicate the leukemic cells. Which stage of therapy is the child undergoing? Delayed intensive-therapy stage Consolidation stage Sanctuary stage Induction stage
Induction stage
Which nursing diagnosis would be most appropriate for a child with idiopathic thrombocytopenic purpura? Risk for infection related to abnormal immune system Ineffective tissue perfusion related to poor platelet formation Ineffective breathing pattern related to decreased white blood count Risk for altered urinary elimination related to kidney impairment
Ineffective tissue perfusion related to poor platelet formation
A nurse is teaching the parents of a child with sickle cell disease about factors that predispose the child to a sickle cell crisis. The nurse determines that the teaching was successful when the parents identify what as a factor? Fluid overload Infection Respiratory distress Pallor
Infection
A 5-year-old client has been diagnosed with leukemia and is currently on chemotherapy and radiation. The child is having difficulty due to mucositis. Which is the most appropriate nursing diagnosis for this child? Risk for imbalanced nutrition, less than body requirements, related to inflammation Compromised family coping, related to long-term chemotherapy regimen Disturbed body image related to loss of hair after chemotherapy Pain due to neoplastic process in bone
Risk for imbalanced nutrition, less than body requirements, related to inflammation
A nurse is preparing a teaching plan for a child with hemophilia and his parents. Which information would the nurse be least likely to include to manage a bleeding episode? Apply heat to the site of bleeding. Apply direct pressure to the area. Administer factor VIII replacement. Elevate the injured area such as a leg or arm.
Apply heat to the site of bleeding.
An adolescent is recovering from surgery, radiation, and chemotherapy following a diagnosis of Ewing sarcoma. Which statement by the family indicates that reteaching is needed? "We will watch for signs of infection and report it to our health care provider." "Our child's friends shaved their heads in solidarity to show their support." "We will remind our child to care for the skin following radiation." "Our child is looking forward to playing football again."
"Our child is looking forward to playing football again."
A mother asks the nurse why her infant who was born at 34 weeks' gestation is being prescribed ferrous sulfate. Which response by the nurse is most appropriate?
"Preterm infants are at risk for iron-deficiency anemia."
The toddler with a cancer diagnosis is seen for a well-child checkup. Which health maintenance activity will the nurse exclude? Administering the measles, mumps, rubella (MMR) vaccine Teaching the importance of taking water safety measures Assessing dietary intake by addressing "picky eating" and "food jags" Plotting height and weight on a growth chart
Administering the measles, mumps, rubella (MMR) vaccine
A 3-year-old child is hospitalized with a diagnosis of sickle cell anemia and is experiencing a pain crisis. Using the FACES scale, the nurse assesses the child's pain to be a 10 on a scale of 1 to 10. The child is receiving intravenous fluids and oxygen at 2 L/min via nasal cannula. The parent is at the bedside holding the child's hand and has a concerned look. What is the nurse's priority in caring for the child? Ask the parent if he or she has questions about the plan of care. Implement strategies to address the child's pain. Contact the health care provider to meet with the parent. Provide diversional activities for the child.
Implement strategies to address the child's pain.
The nurse has been asked to participate in a community health teaching session. Which interventions would the nurse include to help achieve the 2020 National Health Goals to reduce the incidence of anemias? Select all that apply. Examine strategies for elderly community members to improve the quality of life. Emphasize ways to reduce unintentional injuries at home, work, and play. Instruct pregnant women to take iron supplementation as prescribed. Explain the importance of healthy eating for adolescent participants. Review foods that are rich in iron that should be a part of school-age children's diets.
Instruct pregnant women to take iron supplementation as prescribed. Explain the importance of healthy eating for adolescent participants. Review foods that are rich in iron that should be a part of school-age children's diets.
The nurse is caring for a 6-year-old boy with non-Hodgkin lymphoma who is being treated with monoclonal antibodies. What recommendation would the nurse include in the child's plan of care? Assessing the child's hydration status secondary to vomiting Assessing for signs of capillary leak syndrome Monitoring for allergic reactions or anaphylaxis Monitoring for complaints of bone pain
Monitoring for allergic reactions or anaphylaxis
What is the priority action the nurse should take when caring for a child newly diagnosed with Wilms tumor (nephroblastoma)? Assess for constipation. Control acute pain. Protect the abdomen from manipulation. Obtain a catheterized urine specimen.
Protect the abdomen from manipulation.
A nurse is providing care to a child who is to receive a blood transfusion. The health care provider has prescribed the infusion to run at a rate of 5 mL/kg/hour. The child weighs 55 lb The nu(25 kg). At what rate should the nurse set the infusion pump?
The nurse will use the child's weight in kilograms, and multiply weight by the prescribed milligrams per hour. 25 kg × 5 mL = 125 mL/hour
The nurse is caring for a child admitted to the hospital for an open fracture of the femur following a motor vehicle accident. The nurse notes the following lab values: white blood cells 10,000mm3, hemoglobin 7.9 g/dL (79 g/L), hematocrit 28%, platelets 151,000 mm3. Which nursing action is priority? Ask the child to rate pain on a scale 0 to 10. Transfuse 1 unit of packed red blood cells. Administer antibiotics intravenously stat. Provide the family with preop instructions.
Transfuse 1 unit of packed red blood cells.
A 14-year-old girl who is a vegetarian has recently developed anemia. Blood smear results show large, fragile, immature erythrocytes. She claims to take an iron supplement regularly and is surprised to learn that she is anemic, as she is otherwise healthy. The nurse recognizes that this is the likely cause of this type of anemia: Sickle-cell disorder Acute blood loss Vitamin B12 deficiency Iron deficiency
Vitamin B12 deficiency
A nurse is providing care for a child with disseminated intravascular coagulation (DIC). What would alert the nurse to possible neurologic compromise? Equal pupillary response Hematuria Widely fluctuating blood pressure Petechiae
Widely fluctuating blood pressure
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? Encouraging fluid intake to increase radionuclide uptake Administering a sedative as ordered to keep the child still Advising the physician that the child is allergic to shellfish Applying EMLA to the injection site prior to inserting the IV
Administering a sedative as ordered to keep the child still
A 4-year-old child diagnosed with Wilms tumor is admitted for surgery. What information would be most important for the nurse to include in the child's preoperative plan of care? Administering analgesics for pain Avoiding further abdominal palpation Performing dressing changes to the affected area Preparing the child for amputation
Avoiding further abdominal palpation
A 4-year-old child diagnosed with Wilms tumor is admitted for surgery. What information would be mostimportant for the nurse to include in the child's preoperative plan of care? Performing dressing changes to the affected area Avoiding further abdominal palpation Preparing the child for amputation Administering analgesics for pain
Avoiding further abdominal palpation
When providing care for a child immediately after a bone marrow aspiration, which nursing action is priority? Educate the family on proper handwashing. Monitor the site dressing and vital signs. Evaluate pain and administer medication. Allow the child to play with a doll and syringe.
Monitor the site dressing and vital signs.
The nurse is providing postoperative care to a school-age child after a splenectomy and notes the following: temperature 102.1ºF (39ºC), heart rate 120 bpm, respiratory rate 28 breaths/minute, blood pressure 78/36 mm Hg, and oxygen saturation 90%. Which nursing action is priority? Reassess temperature in 30 minutes. Place the child in a supine position. Administer acetaminophen orally. Give recombinant erythropoietin.
Risk for imbalanced nutrition, less than body requirements, related to inflammation
A school nurse is teaching a group of parents about signs and symptoms of cancer in children. Which symptom is an early sign of a brain tumor? projectile vomiting, lethargy, and coma headache, vision changes, and vomiting nystagmus, ataxia, and seizures headache, epistaxis, and dizziness
headache, vision changes, and vomiting
A child with acute lymphoblastic leukemia (ALL) is receiving methotrexate for therapy. Which nursing diagnosis would best apply during therapy? Risk for self-directed violence related to effect of methotrexate on central nervous system Risk for impaired mobility related to depressant effects of methotrexate Risk for impaired skin integrity related to oral ulcerations associated with chemotherapy Excess fluid volume related to effect of methotrexate on aldosterone secretion
Risk for impaired skin integrity related to oral ulcerations associated with chemotherapy
