While caring for a child with leukaemia, a nurse should look for all the following except?

IGNOU Post B. SC. Nursing entrance -2021

Child Health Nursing (Pediatrics)

Hard

Appeared in: IGNOU Post B. SC. Nursing entrance -2021

Explanation

Increased weight gain is the correct answer because it is not a typical sign of leukemia or its treatment; weight loss is the expected finding.
Leukemia is a hypermetabolic condition, meaning the body uses energy at a higher rate, which contributes to weight loss (cachexia).
Side effects of chemotherapy, such as anorexia (loss of appetite), nausea, and vomiting, further impair nutritional intake, leading to weight loss rather than gain.

Option A: This is a hallmark symptom of leukemia. The cancerous cells crowd the bone marrow, suppressing the production of red blood cells, leading to anemia, which manifests as fatigue and weakness.
Option B: This is a very common and expected side effect of the chemotherapy regimens used to treat leukemia. It is a primary focus of supportive care for these patients.
Option C: Alopecia, or hair loss, is a classic and anticipated side effect of many chemotherapy agents because they target rapidly dividing cells, including those in hair follicles.

Clinical Relevance

Nursing practice connection: Use the key finding related to Clinical manifestations and treatment side effects of childhood leukemia to guide bedside assessment, documentation, and the next nursing action.
A nurse's primary role includes meticulous monitoring of the child's weight, nutritional status, and fluid balance. Any significant weight loss requires nutritional intervention.
Symptom management is key. Nurses administer antiemetics to control nausea, provide mouth care for mucositis, and offer psychosocial support for changes in body image like alopecia.
What if the child is on high-dose corticosteroids? In this specific case, the nurse might observe fluid retention, a 'moon face,' and increased appetite, which can cause temporary weight gain. However, this is a specific drug side effect, and the nurse must still monitor for underlying disease-related cachexia and manage nutrition accordingly.

How to Approach the Question

First, identify the negative framing of the question indicated by the word 'except'. This means you are looking for the option that is NOT a typical finding.
Next, consider the pathophysiology of leukemia. It's a cancer of the bone marrow, which will affect blood cell production.
Then, think about the standard treatment for leukemia, which is chemotherapy, and its common side effects.
Evaluate each option: Is this caused by the disease or its treatment? Fatigue (anemia from disease), Nausea/Vomiting (chemo), and Alopecia (chemo) are all expected.
The option that does not fit the typical clinical picture is the correct answer. Cancer generally causes weight loss, making 'increased weight gain' the outlier and the correct choice.

Concept Tested & Keywords

Concept Tested: Clinical manifestations and treatment side effects of childhood leukemia.
Stem keywords: child, leukaemia, caring, nurse
Lead-in keywords: except
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: Question is negatively framed with 'except'.

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