Choose 1 of the following Discussion Topics and provide your answers using appropriate medical terminology.

1. A 3-year-old patient who had a bone marrow transplant 5 weeks ago has grown increasingly listless over the past 2 days, showing little interest in her favorite activities such as riding her tricycle or playing with her dolls. She is easily fatigued and becomes short of breath with minimal activity. She is afebrile, and blood, urine, and sputum cultures were negative for infectious pathogens. Her lungs sound clear, but her breathing is rapid even at rest. Her absolute neutrophil count is zero. She is currently on antibiotics to prevent bacterial infection. Her physician orders an intravenous antifungal agent for her.

Do you think the physicians order is appropriate? Why or why not?
If indeed she has a fungal infection, why were her blood cultures negative and her temperature normal?

2. You are meeting with a newly diagnosed 8-year-old acute lymphocytic leukemia (ALL) patient and his family to answer their questions about his illness and plan for treatment. They had sought medical treatment because the boy had experienced unusual fatigue, repeated infections, and unexplained bruising over the past few months.

The patient and his family want to know why he has problems with bruising and infections when their understanding is that leukemia is a problem with too many white blood cells. How would you answer their question using lay language?
The parents are very afraid of the chemotherapy regimen that is being planned, stating that their 40-year-old cousin died of ALL despite receiving powerful chemotherapy drugs that made him very sick. How would you reassure them without giving them false hope?