5. A toddler with leukemia is hospitalized for fever and neutropenia. Which physician order should a nurse question?
5. A toddler with leukemia is hospitalized for fever and neutropenia. Which physician order should a nurse question?
Test-Taking Tip
The stem asks for "what order should be questioned." The child with neutropenia who has a fever is at greatest risk for infection. Question any order where the risk for infection outweighs a possible benefit.
Content Area: Child Health, Hematological; Integrated Process: Nursing Process, Analysis; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Potential for Alterations in Body Systems
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Answer 1 is correct because rectal medications should be avoided since they pose the risk of trauma to the rectum, which could lead to further infection. A toddler should be able to take Tylenol (acetaminophen) elixir for fever. Answer 2 is incorrect because a child who is neutropenic should have limited visitation due to the high risk for infection. Answer 3 is incorrect because the child is at risk for dehydration and should be well hydrated, which may necessitate a fluid bolus. Answer 4 is incorrect because, although needle punctures of the skin should be avoided in the neutropenic child, granulocyte colony-stimulating factor (G-CSF) is not contraindicated and is given to increase the child's white blood cell count.
