Answer to Question 1
D
Any signs of infection in a child who is immunosuppressed must be reported immediately because it is considered a medical emergency. When a child is neutropenic, pus may not be produced and the only sign of infection may be redness. In a child with neutropenia, a reddened area may be the only sign of an infection. The area should never be massaged. The forearm is not a typical pressure area; therefore, the likelihood of the redness being related to pressure is very small. The observation should be documented, but because it may be a sign of an infection and immunosuppression, the physician must also be notified.
Answer to Question 2
D
An elevated temperature may be the only sign of an infection in an immunosuppressed child. Parents should be instructed to monitor their child's temperature daily because of the risk for infection, but it is not necessary to take a blood pressure daily. Fluid is never withheld as a precaution against increased intracranial pressure. If a child had confirmed CNS involvement with increased intracranial pressure, limiting fluid intake might be more appropriate. Children who are immunosuppressed should not receive any live virus vaccines.
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