The nurse is reviewing the laboratory results of a child with aplastic anemia and notes that the white blood cell (WBC) count is 2000 cells/mm3 and the platelet count is 150,000 cells/mm3
Which of the following nursing interventions will the nurse incorporate into the plan of care? 1. Avoid unnecessary injections.
2. Maintain strict neutropenic precautions.
3. Encourage quiet play activities.
4. Encourage the child to use a soft toothbrush.
2
Rationale: The normal WBC count ranges from 5000 to 10,000 cells/mm3, and the normal platelet count ranges from 150,000 to 400,000 cells/mm3. Strict neutropenic procedures would be required if the WBC count were low to protect the child from infection. Precautionary measures to prevent bleeding should be taken when a child has a low platelet count. These include no in-jections, no rectal temperatures, use of a soft toothbrush, and abstinence from contact sports or activities that could cause an injury.
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Two hours after admission for asthma exacerbation, the 10-year-old boy is lethargic with mottled skin color. He has increased the use of accessory muscles and demonstrates nasal flaring
He is unable to speak and his respiratory rate has increased. The nurse would suspect: 1. Improvement in his condition is imminent. 2. Respiratory failure is imminent. 3. The medical diagnosis is incorrect and the child should be diagnosed with pneumonia. 4. The child may be receiving too much oxygen, which is a respiratory depressant.
A nurse working in the emergency department (ED) notes that a healthcare provider smells strongly of alcohol and appears confused. Which action by the nurse is appropriate?
A) Contact the charge nurse to report the problem. B) Tell the healthcare provider to attend AA. C) Report the healthcare provider to the hospital CEO. D) Report the healthcare provider to the state licensing board.
The clinical nurse leader needs to identify the staff who must go home due to low census. Which answer below describes a democratic style of decision making?
a. The clinical nurse leader identifies the staff person with the most vacation and asks them to go home. b. The clinical nurse leader tells the last person to show up for their shift to go home. c. The clinical nurse leader decides not to send anyone home because it is too difficult to decide who should lose hours. d. The clinical nurse leader asks the group if any of them would like the opportunity to go home and selects staff who volunteer.
Recent trends in childbirth practice indicate that:
a. Delayed pushing is now discouraged in the second stage of labor. b. Episiotomy rates are increasing. c. Midwives perform more episiotomies than physicians. d. Newborn infants remain with the mother and are encouraged to breastfeed.