The father of an 8-year-old male presents to the pediatric clinic for an evaluation of his child.
The father provides a history that the child has had a poor appetite over the past two months,
with increasing fatigue. The child has been complaining that his “Legs hurt”. The father stated
he just thought it was “growing pains” and was not concerned until recently. The boy has been
too fatigued to participate in his favorite sport, baseball. The child's teacher has notified the
parents that the child has been falling asleep during class and not engaging in recess or other
physical activities at school. The child has previously been healthy and is up to date on all
immunizations.
Upon assessment, the nurse notes the child to be pale, with scattered bruises in various stages
on all four extremities. When questioned, the child states he doesn’t remember how the
bruising occurred. The father states that new bruises appear daily, and this has not happened
before. He also states the child has been having nosebleeds frequently. The child also has
enlarged lymph nodes in the neck, axilla, and groin area. The health care provider gives a
preliminary diagnosis of leukemia and refers the client to a pediatric oncologist for a bone
marrow biopsy the following day.
Diagnostics
Complete Blood Count
Result
Hemoglobin(13.5 -17.5 g/dL) 11.4
Hematocrit (40-45%) 36
WBC (4-11 x103/L) 1.4
Platelets (150-400 x103/L) 75
Medications
Medication: Dose: Route:
Multivitamin 1 tablet daily OralIbuprofen 200 mg as needed Oral
1. What are the relevant findings in the case presentation?
2. What are your expectations from the collaboration with the
dietitian, case manager, oncologist, and pharmacist in your case
study?
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