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 statedhe just thought it was “growing pains” and was not concerned until recently. The boy has beentoo fatigued to participate in his favorite sport, baseball. The child's teacher has notified theparents that the child has been falling asleep during class and not engaging in recess or otherphysical activities at school. The child has previously been healthy and is up to date on allimmunizations.Upon assessment, the nurse notes the child to be pale, with scattered bruises in various stageson all four extremities. When questioned, the child states he doesn’t remember how thebruising occurred. The father states that new bruises appear daily, and this has not happenedbefore. He also states the child has been having nosebleeds frequently. The child also hasenlarged lymph nodes in the neck, axilla, and groin area. The health care provider gives apreliminary diagnosis of leukemia and refers the client to a pediatric oncologist for a bonemarrow biopsy the following day.
DiagnosticsComplete Blood CountResultHemoglobin(13.5 -17.5 g/dL) 11.4Hematocrit (40-45%) 36WBC (4-11 x103/L) 1.4Platelets (150-400 x103/L) 75MedicationsMedication: 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 thedietitian, case manager, oncologist, and pharmacist in your casestudy?
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