Chapter 15 & 16 Hematologic System

The nurse is assisting with creating a plan of care for the client with multiple myeloma. Which nursing intervention needs to be included to assess for and prevent renal failure for this client? Select all that apply 1. Encouraging fluids 2. Providing frequent oral care 3. Coughing and deep breathing 4. Monitoring the red blood cell count 5. Monitoring serum calcium and uric acid levels

1. Encourage fluids 5. Monitoring serum calcium and uric acid levels

The nurse is reviewing the laboratory results of a client who is receiving chemotherapy and notes that the platelet count is 10,000 mm3. On the basis of this laboratory value, the nurse would perform which intervention(s)? Select all that apply 1. Monitor stools for occult blood. 2. Keep away from persons who have colds or feel ill. 3. Instruct the client not to bend over at the waist or lift. 4. Floss teeth and rinse mouth with mouthwash after every meal. 5. Instruct the client to blow nose very gently without blocking either nostril.

1. Monitor stools for occult blood 3. Instruct the client not to bend over at the waist or lift 5. Instruct the client to blow nose very gently without blocking either nostril

The nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling. The nurse needs to take which appropriate action? 1. Notify the registered nurse immediately. 2. Administer pain medication to reduce the discomfort. 3. Apply ice and maintain the infusion rate, as prescribed. 4. Elevate the extremity of the IV site, and slow the infusion.

1. Notify the RN immediately

The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase, an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which is documented in the client's history? 1. Pancreatitis 2. Diabetes mellitus 3. Myocardial infarction 4. Chronic obstructive pulmonary disease

1. Pancreatitis

The licensed practical nurse (LPN) is assisting the registered nurse (RN) to create a teaching plan for the client receiving an antineoplastic medication. The LPN expects which information to be included? Select all that apply 1. Rinse mouth after meals and use a soft toothbrush. 2. Notify the PHCP if the temperature is above 101°F (37.7°C). 3. Maintain oral hygiene and inspect the mouth for sores daily. 4. A sore throat is expected so the client would suck on soothing throat lozenges. 5. Consult with a primary health care provider (PHCP) before receiving immunizations.

1. Rinse mouth after meals and use a soft toothbrush. 3. Maintain oral hygiene and inspect the mouth for sores daily. 5. Consult with a primary health care provider (PHCP) before receiving immunizations.

The client with acute myelocytic leukemia is being treated with busulfan. Which laboratory value would the nurse specifically monitor during treatment with this medication? 1. Clotting time 2. Uric acid level 3. Potassium level 4. Blood glucose level

2. Uric acid level

The nurse is reviewing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory finding is indicative of the massive cell destruction that occurs with the chemotherapy? 1. Anemia 2. Decreased platelets 3. Increased uric acid level 4. Decreased leukocyte count

3. Increased uric acid level

The nurse is assisting with creating a plan of care for a client with pancytopenia as a result of chemotherapy. The nurse would suggest including which in the plan of care? Select all that apply 1. Restricting all visitors 2. Restricting fluid intake 3. Restricting fresh fruits and vegetables in the diet 4. Applying a face mask to the client if outside the client room 5. Inserting an indwelling urinary catheter to prevent skin breakdown

3. Restricting fresh fruits and vegetables in the diet 4. Applying a face mask to the client if outside the client room