Pediatric Nursing Q 200
Which of the following would be inappropriate when administering chemotherapy to a child?
A. Monitoring the child for both general and specific adverse effects
B. Observing the child for 10 minutes to note for signs of anaphylaxis
C. Administering medication through a free-flowing intravenous line
D. Assessing for signs of infusion infiltration and irritation
Correct Answer: B. Observing the child for 10 minutes to note for signs of anaphylaxis.
When administering chemotherapy, the nurse should observe for an anaphylactic reaction for 20 minutes and stop the medication if one is suspected. Anaphylaxis is a severe allergic reaction, which can cause shock, low blood pressure, and occasionally death. Food allergies, including allergy to peanuts and tree nuts, are said to account for the majority of fatal or near-fatal anaphylactic reactions in the U.S.A. Care is taken especially when chemotherapy medications are known to be common allergic reaction producers, to premedicate to prevent or lessen the reaction.
Option A: Chemotherapy is associated with both general and specific adverse effects, therefore close monitoring for them is important. A major challenge for the nurse caring for a child with fever and neutropenia is monitoring for signs of sepsis (e.g., peripheral perfusion, temperature of extremities, level of consciousness, vital signs, and pulse oximetry).
Option C: Education of the family and child regarding the treatment plan or protocol (e.g., chemotherapy, radiotherapy, and/or surgery) is crucial to relieving parents’ fears and anxieties. Even though the explanation of the diagnosis and treatment plan supports the hope that their child may survive cancer, the word cancer still conveys a life-threatening illness.
Option D: Because most infectious origins develop from the child’s own endogenous flora, the nurse should encourage the parents/child to adhere to strict handwashing practices, perform frequent mouth care, perineal hygiene, and avoid the use of rectal thermometers owing to the chance of introducing pathogens through the rectal mucosa. Protective isolation and food sterilization have little impact on decreasing infectious rates in neutropenic children.