A child with chronic immune thrombocytopenia presents to the ...

[mspears3]

A child with chronic immune thrombocytopenia presents to the emergency department, where the parents report a 3-day history of severe headache and recent change in mental status. What diagnostic test does the nurse prepare to facilitate as the priority?
 
  A.
  CT of the head
  B.
  Lumbar puncture
  C.
  Platelet count
  D.
  White blood cell count

Question 2

An adolescent has been taught to administer replacement factors for bleeding episodes related to hemophilia. What action by the teen indicates that further instruction is needed?
 
  A.
  Disposes of sharps in an approved container
  B.
  Reconstitutes the medication with sterile water
  C.
  Selects the appropriate needle for an IM injection
  D.
  Washes hands prior to working with the drug

[cici]

Answer to Question 1

ANS: A
A child with ITP is at risk for intracerebral hemorrhage, manifested by changes in level of consciousness, headaches, visual changes, ataxia, and/or slurred speech. The diagnostic test of choice is a CT scan of the head. A lumbar puncture is often used to diagnose meningitis; because this child does not have a fever, meningitis is a low probability. Platelet count and complete blood count (including WBCs) will be done, but the priority is to obtain a head CT.

Answer to Question 2

ANS: C
Replacement factors are given intravenously. The other actions are appropriate.