Pediatric Nursing Q 152
Nurse Hannah is administering a steroid to a child diagnosed with idiopathic thrombocytopenic purpura (ITP); which of the following should the nurse monitor?
A. Infection
B. Anemia
C. Bleeding
D. Bruising
Correct Answer: A. Infection
Steroids may promote immunosuppression, making the child more susceptible to infections. The desired immune-suppressing and anti-inflammatory effects of corticosteroids can also predispose patients to infection. A meta-analysis of 2000 patients found that the infection rate is significantly higher in patients using systemic corticosteroids when the daily dose was 10 mg/day.
Option B: Anemia is not connected to the disorder or medication. Corticosteroid use is associated with hypertension, hyperglycemia, obesity, and conflicting evidence exists regarding hyperlipidemia.
Option C: Acute immune thrombocytopenic purpura can be characterized by generalized purpura in a previously healthy child or, less commonly in an adult, bruises following minor trauma, the presence of oral hemorrhagic bullae, epistaxis, gastrointestinal bleeding, conjunctival hemorrhage, and hematuria.
Option D: Bruising is recognized as a result of the disorder, not the steroid therapy. The chronic immune thrombocytopenic purpura may be characterized by insidious onset or suddenly becomes acute. It is seen more commonly in females and presents with scattered petechiae, epistaxis, and menorrhagia, episodes of bleeding separated by a long period.