Question

The nurse is caring for a four-year-old with acute lymphocytic leukemia. Which finding should be reported to the physician immediately? A. A nosebleed B. Presence of perianal ulcerations C. Painful joints D. Respiratory rate of 26

Short answer

Answer: The presence of perianal ulcerations.

Step-by-step solution

Analyze option A

A nosebleed might be a symptom of low platelet count, which can be a side effect of leukemia or its treatment. However, a single nosebleed is not an emergency situation that requires immediate attention as long as the bleeding is not severe or prolonged.

Analyze option B

Presence of perianal ulcerations could be a sign of an underlying infection which could pose a serious threat to the patient, especially due to the weakened immune system caused by leukemia. This finding should raise concern and should be reported to the doctor immediately.

Analyze option C

Painful joints can be a symptom of leukemia, but it is not an emergency situation. Pain might be managed with painkillers based on a physician's advice, but it doesn't need immediate attention.

Analyze option D

A respiratory rate of 26 in a four-year-old is slightly elevated but not dangerously high. The normal breathing rate for a child of this age is around 20 to 30 breaths per minute. Although it is worth monitoring, it doesn't require urgent attention.

Identify the correct immediate response

Based on the analysis of the four options, presence of perianal ulcerations (Option B) is the finding that should be reported to the physician immediately, as it could indicate a serious infection in the patient with a weakened immune system due to the leukemia.