Complex Cases 01192018
An oncology patient has begun to experience skin reactions to radiation therapy, prompting the nurse to make the diagnosis Impaired Skin Integrity: erythematous reaction to radiation therapy. What intervention best addresses this nursing diagnosis?
Avoid rubbing or scratching the affected area
How do you, as the nurse, prevent nosocomial infection of a cancer patient? (Mark all that apply)
Adequate and proper hand washing The patient avoids contact with individuals who recently have had a live vaccination Ensure the equipment is properly cleaned or disposed of when caring for a patient.
A client in a hospice program has increasing pain. The nurse and the client collaborate to schedule analgesics to provide:
Around the clock routine administration of analgesics for continuous pain relief
A nurse is caring for a terminally ill cancer client who is being transferred to hospice care. Which information regarding hospice care would the nurse include in the teaching plan? Select all that apply.
Bereavement care is provided to the family (terminally ill cancer client ) The focus of care is on controlling symptoms and relieving pain (terminally ill cancer client) A multidisciplinary team provides care (terminally ill cancer client)
A child with leukemia has been exposed to chickenpox. The child's mother calls the health care provider office and asks the nurse if her child needs to have anything done. What is the nurse's most appropriate response?
Bring the child because in this case chicken pox can be lethal
A nurse provides care on a bone marrow transplant unit and is preparing a female patient for a hematopoietic stem cell transplantation (HSCT) the following day. What information should the nurse emphasize to the patient's family and friends? (select all that apply)
Do not visit if you have had a recent infection. Make sure she doesn't eat any raw foods in 24 hours before the procedure Wear a mask and gown when you go into the patient's room
A client who is near death is receiving hospice care to manage severe pain. The client is receiving morphine IV through a PCA. The client is lethargic and is sleeping much of the time and has not had any pain for the last 12 hours. The nurse plans care based on the fact the client:
Has obtained sufficient pain relief because of not having pain in the last 12 hours.
A four year old child has recently been diagnosed with ALL (acute lymphocytic leukemia). What information about ALL should the nurse provide when educating the child's parent's? Select all that apply.
Leukemia is a rare form of childhood cancer Adverse effects of treatment include sleepiness, alopecia, and stomatitis There is a 95% chance of remission with treatment
A 60-year-old patient with a diagnosis of prostate cancer is schedule to have an interstitial implant for high-dose radiation (HDR). What safety measure should the nurse include in this patient's subsequent plan of care?
Limit the amount of time that visitors spend at the patient's bedside
A 4 year old child is diagnosed as having acute lymphocytic leukemia. The white blood cell count, especially the neutrophil count is low. What is the most important intervention the nurse should teach the parents?
Protect the child from infections because their resistance to infection is decreased
The nurse is caring for a patient with an advanced state of breast cancer and the patient has recently learned her cancer has metastasized. The nurse enters the room and finds the patient struggling to breathe and the nurse's rapid assessment reveals the patient's jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
Superior vena cava syndrome
What is the most important common factor between medications such as steroids like dexamethasone and chemotherapeutic agents?
These drugs reduce immunity and significantly increase risk for infection
A nurse is caring for a patient who is undergoing chemotherapy. Current lab values are noted: Hemoglobin 12, platelet count 108,000, WBC 1600, ANC <1000. What intervention is the most appropriate for the nurse to implement?
Washing hands before and after entering the room
Which of the following would not be considered when caring for veterans at the end of life?
Whether the veteran deserves a military funeral
The most reliable early indicator of infection in a client who is neutropenic is?
fever
Mr. W is a 65 year old male has been treated in the last year for an aggressive cancer. He has been receiving 2 chemotherapeutic agents once a month for the last 6 months, and has been receiving high dose corticosteroid therapy. He has been admitted secondary to dehydration and on day 3 of admission he develops an acute headache. He is normotensive, vital signs stable, and CT of the head is negative for any acute process. What is your next priority action as a nurse?
get an order for labs and spinal tap
commonality of corticosteroid and chemo therapy
immunosuppression
The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient care, what is the most potential adverse effect(s) that the nurse should discuss with the patient?
impaired nutritional changes
A client suspects that he will not live. However, others talk about only pleasant matters with him and maintain a persistently cheerful facade around him. The nurse plans care for this client by recognizing that these behaviors will most likely cause the client to feel:
isolated
no. 1 germ transporters in the hospital
pens
A patient with pancreatic cancer has a Whipple procedure performed to resect the tumor. The nurse recognizes that hemorrhage is a potentially major complication of the Whipple procedure. Which of the following assessment findings suggest this complication?
urinary output 15 ml/hr
adverse effects of chemo
weight loss, N&V,
