Nokea
A 2-year-old child has been diagnosed with hemophilia A. What information should the nurse include in a teaching plan about home care?
- A. If bleeding occurs, apply pressure, ice, elevate, and rest the extremity.
- B. Children's aspirin in lowered doses may be given for joint discomfort.
- C. A firm, dry toothbrush should be used to clean teeth at least twice a day.
- D. Do not permit interactive play with other children.
Correct Answer: A
Rationale: When bleeding occurs, the traditional approach is to follow RICE - rest, ice, compression, and elevation.
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An adolescent is diagnosed with Hodgkin's 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?
- A. I
- B. II
- C. III
- D. IV
Correct Answer: C
Rationale: Lymph node regions on both sides of the diaphragm are consistent with a diagnosis of stage-III Hodgkin's disease.
The nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities. Which lab value is consistent with these symptoms?
- A. Platelet count of 25,000/mm?³
- B. Hemoglobin level of 8 g/dL
- C. Hematocrit level of 36%
- D. Leukocyte count of 14,000/mm?³
Correct Answer: A
Rationale: The normal platelet count is 150,000 to 400,000/mm?³. This finding is very low, indicating an increased bleeding potential.
What should the nurse closely assess in a child receiving a transfusion?
- A. Fever
- B. Lethargy
- C. Jaundice
- D. Bradycardia
Correct Answer: A
Rationale: The child receiving a blood transfusion is observed for signs of a transfusion reaction including chills, itching, fever, rash, headache, and back pain.
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 children's risk of inheriting this disease?
- A. Every fourth child will have the disease; two others will be carriers.
- B. All of their children will be carriers, just as they are.
- C. Each child has a one in four chance of having the disease and a two in four chance of being a carrier.
- D. The risk levels of their children cannot be determined by this information.
Correct Answer: C
Rationale: The sickle cell gene is inherited from both parents; therefore, each offspring has a one in four chance of inheriting the disease.
The child receiving a transfusion complains of back pain and itching. What is the best initial action by the nurse?
- A. Notify the charge nurse.
- B. Disconnect intravenous lines immediately.
- C. Give diphenhydramine (Benadryl).
- D. Clamp off blood and keep line open with normal saline.
Correct Answer: D
Rationale: If a blood transfusion reaction occurs, the first action is to stop the blood infusion, keep the line open with normal saline, and notify the charge nurse.