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    Ati Rn Paediatrics Nursing 2023 Proctored Exam

    A nurse is admitting an 8-year-old child to the pediatric unit. For each potential condition, click to specify if the child's assessment findings are consistent with Hodgkin Lymphoma, Bacterial Meningitis, or Acute Lymphoblastic Leukemia (ALL). Each finding may support more than 1 disease process.

    Explanation & Rationale

    • Neurologic: The child exhibits headache, lethargy, irritability, and nuchal rigidity, indicating neurologic involvement. These findings are classic for bacterial meningitis due to meningeal inflammation. While ALL can involve the CNS, it rarely presents with acute nuchal rigidity unless there is a secondary complication. • Skin: The child has a facial rash with purple-red blotches, which can appear in ALL due to thrombocytopenia. Skin manifestations such as rashes may also occur with bacterial infections like meningitis suggesting Neisseria meningitidis (meningococcemia), a life-threatening emergency. • Pain: Headache, irritability, and general discomfort indicate pain. Bacterial meningitis causes intense headache and malaise due to meningeal inflammation. ALL may produce bone and joint pain due to marrow expansion from leukemic proliferation. • Lymph nodes: Painless lymphadenopathy is classic for Hodgkin lymphoma, typically involving cervical and supraclavicular nodes. ALL can also cause lymphadenopathy due to infiltration of malignant lymphoblasts. Bacterial meningitis can present with painful lymph node enlargement due t infection,

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