The nurse is reviewing the laboratory and diagnostic test results ...

[Destiiny22]

The nurse is reviewing the laboratory and diagnostic test results of a child scheduled to be seen in the clinic. The nurse notes that the physician documented that diagnostic studies revealed the presence of Reed-Sternberg cells.
 
  The nurse prepares to assist the physician to discuss which of the following with the parents of the child? 1. Treatment options for leukemia
  2. Treatment options for neuroblastoma
  3. Treatment options for Hodgkin's disease
  4. Treatment options for infectious mononucleosis

Question 2

An adolescent client with severe cystic acne has been prescribed isotretinoin (Accutane). Which statement by the client would suggest the need for further teaching?
 
  1. I will return to the clinic for blood tests.
  2. If my lips begin to burn, it is probably because of the medication.
  3. My eyes may become dry and burn as a result of the medication.
  4. I need to take my vitamin A supplement so that the treatment will work.

[joanwhite]

Answer to Question 1

3

Rationale: Hodgkin's disease is a neoplasm of lymphatic tissue. The presence of giant, multinu-cleated cells (Reed-Sternberg cells) is the hallmark of this disease. The presence of blast cells in the bone marrow is indicative of leukemia. Infectious mononucleosis and Epstein-Barr virus have been associated with Hodgkin's disease, but the exact relationship is unknown. Elevated vanillylmandelic acid (VMA) urinary levels are found in children with neuroblastoma.

Answer to Question 2

4

Rationale: Isotretinoin (Accutane) is used to inhibit inflammation in the client with severe cystic acne. Adverse effects include elevated triglyceride levels, skin dryness, and eye discomfort, such as dryness and burning. Lip inflammation, called cheilitis, can also occur. Vitamin A supplements are stopped during this treatment because of their additive effects.