36.A toddler who presents with anemia and reticulocytopenia has ahistory of a gradual decrease in energy and increase in pallor beginningafter a recent viral infection. How will the primary care pediatric nursepractitioner treat this child? a.Closely observe the child’s symptoms and lab values.b.Consult with a pediatric hematologist.c.Prescribe supplemental iron for 4 to 6 months.d.Refer for transfusions to correct the anemia.ANS: AThis child has symptoms and a history consistent with transienterythroblastopenia of childhood (TEC), which is usually self-limited. The PNPshould monitor the child closely without treatment unless the anemia getsworse. Any of the other options may be necessary if the child’s conditionworsens. 37. The primary care pediatric nurse practitioner is managing care for achild diagnosed with iron-deficiency anemia who had an initial hemoglobinof 8.8 g/dL and hematocrit of 32% who has been receiving ferrous sulfateas 3 mg/kg/day of elemental iron for 4 weeks. The child’s current lab workreveals elevations in Hgb/Hct and reticulocytes with a hemoglobin of 10.5
g/dL and a hematocrit of 36%. What is the next step in management ofthis patient? 38.The primary care pediatric nurse practitioner is performing a well childexamination on a school-age child who has a history of cancer treatedwith cranial irradiation. What will the nurse practitioner monitor in thischild?
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