The pathophysiology of venous thrombosis is often explained by Virchow's triad, which includes hypercoagulability, endothelial injury, and venous stasis. Based on Virchow's triad and your knowledge of risk factors for thrombosis, which of the following pediatric patients has the greatest risk of hospital-acquired venous thromboembolism?

Correct Answer: C

Rationale: The correct answer is C because the ex-28 week premature infant requiring NICU-level care for necrotizing enterocolitis has the greatest risk of hospital-acquired venous thromboembolism. Premature infants are at higher risk due to their immature coagulation system and prolonged immobility. Necrotizing enterocolitis further increases the risk due to inflammation and endothelial injury. Hypercoagulability is common in premature infants. Choices A, B, and D have lower risk as they do not have the same combination of risk factors as the premature infant in choice C.

Correct Answer: D

Rationale: The correct answer is D: Place the client on safety precautions. With a platelet count of 58,000/mm3, the client is at risk for bleeding due to thrombocytopenia. Placing the client on safety precautions will help prevent injuries and minimize bleeding risks. This includes using a soft-bristled toothbrush, avoiding IM injections, and using caution with activities that may cause trauma. A: Encouraging high-protein foods is not directly related to managing the client's thrombocytopenia. B: Neutropenic precautions are for clients with low white blood cell counts, not low platelet counts. C: Limiting visitors to healthy adults is important for clients with compromised immune systems, not specifically for thrombocytopenia.

Correct Answer: C

Rationale: The correct answer is C: Excessive alcohol consumption. Excessive alcohol intake can lead to hematologic health problems such as anemia and abnormal blood clotting. Alcohol interferes with the production of red blood cells and impairs the function of platelets. Therefore, documenting excessive alcohol consumption is crucial in assessing a client's risk for hematologic issues. Explanation for why other choices are incorrect: A: Family history of military excellence - This choice is irrelevant to hematologic health problems and does not pose a risk factor. B: Diet low in iron and protein - While a poor diet can contribute to hematologic issues, this specific choice does not directly indicate a risk factor for hematologic problems. D: Family history of allergies - Allergies are not directly related to hematologic health problems, so this choice is not relevant in this context.

Correct Answer: A

Rationale: Step-by-step rationale: 1. Subcutaneous injection of heparin is avoided due to the risk of hematoma formation at the injection site. 2. This statement is false because heparin is commonly administered subcutaneously for prophylaxis of thromboembolic events. 3. The preferred route for heparin administration is subcutaneous or intravenous. 4. Therefore, choice A is the false statement. Summary: - Choice A is incorrect as heparin is commonly given subcutaneously. - Choice B is incorrect as heparin is not stored in mast cells but in specialized granules in mast cells. - Choice C is correct as heparin binds to plasma antithrombin III to inhibit thrombin. - Choice D is correct as protamine sulfate can reverse heparin's anticoagulant effects in case of overdose.

Correct Answer: C

Rationale: The correct answer is C: Trypanosoma brucei gambiense. This is the most probable causative organism because the patient's presentation of fever and posterior cervical lymphadenopathy over a prolonged period aligns with the chronic infection caused by Trypanosoma brucei gambiense, which leads to African Trypanosomiasis (sleeping sickness). Trypanosoma cruzi (choice A) causes Chagas disease, which typically presents with acute symptoms such as fever and swelling at the site of infection. Trypanosoma brucei rhodesiense (choice B) causes acute African Trypanosomiasis with a more rapid progression compared to gambiense. Leishmania donovani (choice D) causes visceral leishmaniasis, which presents with prolonged fever, splenomegaly, and pancytopenia, but not typically with cervical lymphadenopathy.