An 8-year-old child had a hematopoietic stem cell transplant 10 ...

[leo leo]

An 8-year-old child had a hematopoietic stem cell transplant 10 months ago. The father brings her to the clinic, where the child reports I just don't feel well. Dad relates that the child has been lethargic and sleeping a lot.
 
  The child's vital signs are within normal range for age. What action by the nurse is best?
  A.
  Explain that growth spurts can cause fatigue.
  B.
  Prepare the family for a fever workup.
  C.
  Provide reassurance to the father and child.
  D.
  Review side effects of immunosuppressants.

Question 2

A child is suspected of having aplastic anemia. What physical assessment should the nurse perform to correlate with this condition?
 
  A.
  Abdominal palpation
  B.
  Lung auscultation
  C.
  Oral assessment
  D.
  Skin inspection

[yifu223]

Answer to Question 1

ANS: B
After a stem cell transplant, patients are on lifelong immunosuppressant therapy. These patients may contract illnesses, especially infections, without showing the classic signs and symptoms. The nurse should assume the child has an infection and prepare the child and father for a full workup to determine the origins of the infection. Reassurance is always an important nursing intervention, but does not take priority over the child's physical health. At each clinic visit, the nurse should review the treatment regimen, including side effects of medications, but again this is not the priority. Until proven otherwise, this child is ill, and not just having a growth spurt.

Answer to Question 2

ANS: A
Children with aplastic anemia do not have hepatosplenomegaly, so when palpating the abdomen, it feels normal. The other assessments are not as specific for findings in this disease.

[leo leo]

Thank you

[yifu223]

No problemo