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The nurse analyzes the laboratory values of a pediatric client with leukemia who is receiving chemotherapy. The nurse notes the following lab values: platelets 19,500/mcl (nl. 140,000-400,000/mcL), hemoglobin 11 g/dL (nl. 12-16 g/dL), white blood cell count 9,800/mcl (nl. 5,000-10,000/mcL). Based on these findings, which intervention should the nurse prioritize in the plan of care?

A.

Monitoring closely for signs of infection.

B.

Transfusing packed red blood cells.

C.

Administering intravenous immunoglobulins.

D.

Initiating bleeding precautions.

Answer and Explanation

The Correct Answer is D

Rationale:

 

A. Monitoring for infection is important, but the white blood cell count is within normal limits, so it is not the immediate priority.

 

B. Although the hemoglobin is slightly low, it is not critically low, so transfusion of packed red blood cells is not immediately necessary.

 

C. Intravenous immunoglobulins are not indicated based on the current lab values.

 

D. The platelet count is critically low, placing the client at high risk for bleeding. Initiating bleeding precautions is the priority to prevent hemorrhage.


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Correct Answer is B

Explanation

Rationale:

A. While pain management is important, the primary treatment for pyloric stenosis is surgical correction, not just analgesic medication.

B. Preparation for surgical correction, specifically a pyloromyotomy, is the standard treatment for pyloric stenosis to relieve the obstruction.

C. A barium enema is not used in the diagnosis or treatment of pyloric stenosis; it is typically used to diagnose other gastrointestinal conditions.

D. Thickened feedings with rice cereal are not indicated for pyloric stenosis and would not resolve the obstruction.

Correct Answer is A

Explanation

Rationale:

A. Circumcision is often delayed in newborns with hypospadias because the foreskin may be needed for the surgical repair of the urethra.

B. While surgery is necessary, it is not typically an emergency; it is planned and performed later in infancy.

C. In hypospadias, the urethral opening is located on the underside (ventral side) of the penis, not the top.

D. Undescended testicles (cryptorchidism) are a separate condition from hypospadias.

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