Navigating Lab Values for Pediatric Patients Undergoing Chemotherapy

Which lab value should a nurse report for a 6-year-old receiving chemotherapy?

• A. WBC 4,500 cells/uL
• B. Hgb 8.5 g/dL
• C. Platelets 250,000 cells/uL
• D. Hct 35%

Answer: (B)

For a 6-year-old child undergoing chemotherapy, a hemoglobin level of 8.5 g/dL is concerning and should be reported. Chemotherapy can lead to a decrease in red blood cells due to its effects on the bone marrow, where blood cells are produced. Normal hemoglobin levels for a child in this age range typically fall between 11.5 g/dL and 13.5 g/dL. A level of 8.5 g/dL indicates anemia, which can lead to symptoms such as fatigue, weakness, and increased susceptibility to infections. Therefore, identifying and reporting this abnormality is crucial for the child's safety and may warrant intervention, such as a blood transfusion or further investigation into the cause of the anemia. In this context, the other lab values do not indicate immediate concern. A white blood cell count of 4,500 cells/uL is within the normal range, suggesting that the child does not have leukopenia, which is often a side effect of chemotherapy. A platelet count of 250,000 cells/uL demonstrates adequate platelet levels, indicating that the child does not currently have thrombocytopenia, which would elevate the risk of bleeding. Similarly, a hematocrit level of 35

When it comes to pediatric nursing, understanding lab values is like navigating a maze—each turn leads to new insights about patient care. For example, take the scenario of a 6-year-old child undergoing chemotherapy. Their delicate health demands a keen eye on lab results, particularly hemoglobin levels. But why does this matter so much? Well, with chemotherapy often comes a drop in red blood cells, making the interpretation of hemoglobin levels crucial for patient safety.

Imagine you’re a nurse reviewing lab results. You come across the options: a white blood cell count of 4,500 cells/uL, hemoglobin at 8.5 g/dL, platelets at 250,000 cells/uL, and hematocrit at 35%. Out of these, the hemoglobin level of 8.5 g/dL stands out like a flashing neon sign. It’s not just a number; it tells a story of potential anemia and a child's growing fatigue, weakness, and susceptibility to infections. Isn’t it fascinating how numbers can reflect a child's condition?

For context, hemoglobin levels for a healthy 6-year-old typically hover between 11.5 g/dL and 13.5 g/dL. So when you spot a value of 8.5 g/dL, it should hit you like a soft thud in your gut—this level is concerning and warrants immediate reporting. Why? Because low hemoglobin in children can lead to serious complications if left unaddressed.

Now let’s break down the other lab values. A white blood cell count of 4,500 cells/uL is quite normal, which is a sigh of relief, as leukopenia—a common side effect of chemotherapy—doesn't seem to be an issue here. Similarly, a platelet count of 250,000 cells/uL indicates a healthy level, which reduces the risk of bleeding. And, a hematocrit level of 35% doesn’t raise alarms either. So why focus solely on hemoglobin? Because in pediatric care, especially for those undergoing treatment, every detail counts.

In life and in nursing, anticipation is key. Recognizing abnormal lab values, particularly concerning hemoglobin, is a crucial skill every nurse must master—after all, it's about more than just numbers. It’s about the well-being of these young patients, their families, and everyone involved in their care. So the next time you find yourself knee-deep in lab results, remember to give those hemoglobin levels a good look. They just might tell you a story worth listening to.