A child is hospitalized with the following laboratory values: ...

[acc299]

A child is hospitalized with the following laboratory values: WBCs, 2,100 mm3; segs, 48; and bands, 2. What action by the nurse is best?
 
  A.
  Move the child to a laminar airflow room.
  B.
  Place the child on strict protective isolation.
  C.
  Use good hand hygiene measures consistently.
  D.
  Wear a mask when entering the child's room.

Question 2

A hospitalized child is receiving antithymocyte globulin (ATG) for aplastic anemia. What action by the nurse is most important?
 
  A.
  Assess the IV site for good blood return.
  B.
  Ensure emergency equipment is nearby.
  C.
  Obtain informed consent for each dose.
  D.
  Pad side rails and institute seizure precautions.

[mbcrismon]

Answer to Question 1

ANS: C
This child's absolute neutrophil count (ANC) is 1,050 mm3, which is classified as minimal, or class 2, neutropenia. Good hand hygiene and keeping sick visitors away from the child should be sufficient. Protective isolation is usually not used until the ANC falls below 500 mm3. Laminar airflow may or may not be used; this modality is often used for patients with tuberculosis. A mask is not needed.

Answer to Question 2

ANS: B
ATG is made from horse or rabbit serum and can cause anaphylaxis, even after test dosing. The nurse ensures that appropriate emergency equipment is available in case of such an emergency. Assessing the IV site is also an important action, but does not take priority over being prepared for an emergency. Informed consent is not required for each dose. Seizure precautions are not needed.