When caring for a child with a very low platelet count, what should the nurse monitor in the child's urine?

When caring for a child with a very low platelet count, monitoring for erythrocytes (red blood cells) in the urine is particularly important. A low platelet count, also known as thrombocytopenia, increases the risk of bleeding, which can manifest in various ways, including hematuria—visible or microscopic blood in the urine. When the platelets are insufficient to prevent bleeding, even minor trauma can lead to blood entering the urinary system and being excreted in the urine.

Monitoring for erythrocytes in the urine helps healthcare providers assess the child's risk for bleeding and guide further management and interventions. Identifying the presence of blood can prompt investigations to determine the source of the bleeding, which can be crucial in this population with thrombocytopenia.

Other options like glucose, protein, and ketones in the urine, while important in different clinical contexts, do not have the same direct association with low platelet counts and bleeding risk.