A school-age child has leukemia. Considering the diagnosis and health teaching needs, the nurse would be most correct in advising this child to:
  1. Skip brushing the teeth at this time.
  2. Brush the teeth with a soft toothbrush only.
  3. Brush the teeth with a firm toothbrush only.
  4. Rinse the mouth with an antiseptic solution instead of brushing the teeth.
Explanation
Answer - B - Brushing the teeth with a soft toothbrush can prevent bleeding gums due to thrombocytopenia, which is common in children with leukemia; in addition, chemotherapy may also cause oral mucous membrane ulceration. Choice C is not applicable because it might cause a break in the gums, leading to infection. Rinsing the mouth only (Choice D) might also lead to infection, because this would not necessarily clean the gums and teeth adequately; likewise, infection might be caused by not brushing the teeth (Choice A).
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