A 7-year-old child presents to the emergency department, where ...

[khang]

A 7-year-old child presents to the emergency department, where the parent reports a 3-week history of pale skin, extreme fatigue, and dizziness. Which laboratory value would the nurse correlate with the patient's current condition?
 
  A.
  Hematocrit: 33
  B.
  Hemoglobin: 13.2 g/dL
  C.
  Red blood cell count: 2.8/mm3
  D.
  White blood cell count: 12.3/mm3

Question 2

A parent brings a child to the clinic and reports that the child is reluctant to walk and has a new limp. The parent also reports that the child seems lethargic and tired all the time. The nurse notes that the child appears pale.
 
  Which other finding would warrant immediate notification of the health-care provider?
  A.
  Difficulty staying asleep at night
  B.
  Left-sided abdominal enlargement
  C.
  Polyphagia and polydipsia
  D.
  Swelling of the legs and feet

[Harbringer]

Answer to Question 1

ANS: C
For a child of this age, a normal RBC count is 4-5.2/mm3. Low RBCs can lead to pallor, fatigue, headaches, and dizziness, as tissues are not being oxygenated. The other laboratory values are normal.

Answer to Question 2

ANS: B
This child has some manifestations of acute lymphocytic leukemia (ALL). Left-sided abdominal enlargement could be indicative of splenomegaly, which is another manifestation of this disease. The nurse should report these findings immediately. Difficulty staying asleep at night is vague and could be related to a number of causes, both physical and behavioral. Polydipsia and polyphagia are two of the three classic signs of diabetes. Swelling of the legs and feet is not a manifestation of ALL.

[khang]

TYSM

[Mochi]

Excellent