PrepU Adult 2 Assignment 8

A client with lymphedema is struggling with negative emotions related to her appearance. Which of the following suggestions from the nurse would be most effective in helping the client address the problem?

"Let's discuss some clothing styles that can help conceal the problem while you are being treated."

A 70-year-old client has recently been diagnosed with lymphoma and asks what may have contributed to this illness. Which of the following statements from the nurse would be most accurate?

"Lymphoma incidence increases with age because of cumulative exposures to carcinogens and a decline in immune functioning."

A client is recovering from infectious mononucleosis and asks the nurse when he or she will finally be rid of the disease. How should the nurse most accurately respond?

"You are now immune to mono, but the virus will remain in your body for the rest of your life."

A client recently diagnosed with a lymphatic disorder asks the nurse why the lymphatic system is so important. Which of the following would the nurse be correct in identifying as potential complications of a compromised lymphatic system? Select all that apply.

-Fluid distribution problems -Tender, painful enlargement of lymph nodes -Weakened immunity

After chemotherapy for AML, what interventions will best help to prevent renal complications? Select all that apply.

-Increase hydration. -Administer allopurinol. -Administer rasburicase.

A client has been diagnosed with infectious mononucleosis. He asks the nurse how he contracted the illness. Which of the following would the nurse accurately identify as possible causes of the client's condition? Select all that apply.

-Kissing -Sharing cigarettes -Being coughed or sneezed on

What is included in the management of lymphadenitis? Select all that apply.

-broad-spectrum antibiotic -elevate the extremity

Lindsay Sergeant, a 16-year-old high school student, is presenting at the primary care group where you practice nursing. She presents with severe fatigue, sore throat, headache, oozing tonsils and cervical lymph node enlargement. Considering the incubation period for Epstein-Barr virus, when would you estimate her exposure?

30 - 50 days ago

Which patient assessed by the nurse is most likely to develop myelodysplastic syndrome (MDS)?

A 72-year-old patient with a history of cancer

A client who is undergoing chemotherapy for AML reports pain in the low back. What is the nurse's first action?

Assess renal function.

The nurse practitioner suspects that a patient has multiple myeloma based on his major presenting symptom and the analysis of his laboratory results. Select the classic symptom for this disease.

Bone pain in the back of the ribs

Which precautions should a nurse include in the care plan for a client with leukemia and neutropenia?

Eliminate fresh fruits and vegetables, avoid using enemas, and practice frequent hand washing.

A client who is being treated for AML has bruises on both legs. What is the nurse's most appropriate action?

Evaluate the client's platelet count.

The nurse is documenting findings in a client with lymphedema. Although the client reports no pain or limitations and there are no signs of infection, the affected limb is 3 cm larger in circuference than the unaffected limb. How should the nurse grade this client's lymphedema?

Grade I

A patient with acute myeloid leukemia (AML) is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. In which complication do the donor's lymphocytes recognize the patient's body as foreign and set up reactions to attack the foreign host?

Graft-versus-host disease

When assessing a female client with a disorder of the hematopoietic or the lymphatic system, which assessment is most essential?

Health history, such as bleeding, fatigue, or fainting

Riley Thomas, a 23-year-old graduate student, presents at the primary care group where you practice nursing with painless enlargement of the cervical and axillary lymph nodes. He has lost 20 pounds in the last two months and reports an alarming lack of energy. His history is positive for infectious mononucleosis when he was a young teen. From what might Riley be suffering?

Hodgkin's lymphoma

A patient with AML is having aggressive chemotherapy to attempt to achieve remission. The patient is aware that hospitalization will be necessary for several weeks. What type of therapy will the nurse explain that the patient will receive?

Induction therapy

The nurse is administering packed red blood cell (RBC) transfusions for a patient with myelodysplastic syndrome (MDS). The patient has had several transfusions and is likely to receive several more. What is a priority for the nurse to monitor related to the transfusions?

Iron levels

A patient is taking hydroxyurea for the treatment of primary myelofibrosis. While the patient is taking this medication, what will the nurse monitor to determine effectiveness?

Leukocyte and platelet count

Gloria Donaldson, a 34-year-old mother of four, presents at the ED where you practice nursing with an elevated temperature and red, swollen, painful left axillary lymph nodes with visible red streaks. What would you expect the physician to diagnose?

Lymphadenitis

A nurse is helping to prepare a client with lymphedema for a procedure in which an intravenous dye and radiography will be used to detect lymph node involvement and reveal the degree and extent of blockage in the lymph system. What procedure will the client be undergoing?

Lymphangiography

Which term refers to a form of white blood cell involved in immune response?

Lymphocyte

A client has been diagnosed with lymphoma and asks the oncologist for more information about the diagnosis. Which specifics would be included in a diagnosis of non-Hodgkin's lymphoma?

No Reed-Sternberg cells; B- and T-cell origin; common in abdomen and tonsils; can develop in areas other than lymph nodes

A 16-year-old girl has been brought to her primary care provider by her mother due to the daughter's recent malaise and lethargy. Which of the following assessments should the clinician perform in an effort to confirm or rule out infectious mononucleosis?

Palpating the patient's lymph nodes

Which term refers to an abnormal decrease in white blood cells, red blood cells, and platelets?

Pancytopenia

The nurse is performing an assessment on a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. What laboratory study should the nurse be concerned about?

Platelet count of 9,000/mm3

A young adult is preparing to begin treatment for non-Hodgkin lymphoma (NHL), a disease that has disseminated widely. What is the most likely treatment regimen for this patient that the nurse will help prepare?

Radiation and chemotherapy

The nurse is reviewing the chart of a client with lymphoma. Which of the following findings would best indicate to the nurse that the client has Hodgkin's disease as opposed to non-Hodgkin's lymphoma?

Reed-Sternberg cells are found diagnostically.

A client hospitalized with Hodgkin's disease is currently under visitor restrictions and asks the nurse why this is necessary. Which of the following explanations from the nurse is most accurate?

Restricting visitors and personnel reduces the risk of transmission of pathogens to the client.

The nurse is assessing a patent with polycythemia vera. What skin assessment data would the nurse determine is a normal finding for this patient?

Ruddy complexion

A client with suspected multiple myeloma is reporting back pain. What is the priority nursing action?

Send the client for a spinal x-ray study.

Which term is used to refer to a primitive cell that is capable of self-replication and differentiation?

Stem cell

Laboratory and diagnostic test results have returned for a client with suspected lymphangitis. Which of the following would be most likely for the nurse to review in the results?

Streptococcus

Will Gleason, a 57-year-old bartender, has an appointment with a physician in the primary care group where you practice nursing. Mr. Gleason presents with weeping lower extremity edema, his skin is thickened and brawny. This condition has been present for four weeks and he is seeking treatment. What treatment would you expect the physician to order?

Symptomatic treatment

The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma?

The client with enlarged lymph nodes in the neck.

Which statement best describes the function of stem cells in the bone marrow?

They produce all blood cells.

Wilkins Booth, a 70-year-old male, is a client in the long-term care facility where you practice nursing. Mr. Booth has a history of lymphedema. What is an important part of your assessment as a result of impaired nutrition to his tissues?

Ulcers and infection in the edematous area

A client who has Hodgkin's disease should have their bed in high-Fowler's position whenever practical to:

increase lung expansion.

A client with Hodgkin's disease is receiving chemotherapy with the regimen called "MOPP." For which of the following drugs does the "M" stand?

mechlorethamine (Mustargen)

A client presents with weeping lower extremity edema and skin that is thickened and brawny. This condition has been present for 4 weeks. The physician would likely order:

symptomatic treatment.

A client has a history of lymphedema. Impaired nutrition to the client's tissues could lead to:

ulcers and infection in the edematous area.

A client is recovering from infectious mononucleosis. For which of the following conditions is the nurse aware that the client may also be at increased future risk?

Hodgkin's lymphoma

A client at the health care facility is diagnosed with Hodgkin's disease that has extended to the liver. What stage should the nurse use to describe the progress of the disease?

Stage IV

The nurse is caring for a patient with acute myeloid leukemia (AML) with high uric acid levels. What medication does the nurse anticipate administering that will prevent crystallization of uric acid and stone formation?

Allopurinol (Zyloprim)

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia?

Apply prolonged pressure to needle sites or other sources of external bleeding.

A client with Hodgkin's disease is hospitalized and experiencing respiratory distress. In which position should the nurse place the client?

High Fowler's

Lindsay Sergeant, a 16-year-old high school student, is presenting at the primary care group where you practice nursing. She presents with severe fatigue, sore throat, headache, oozing tonsils and cervical lymph node enlargement. Which of the accessory lymphatic structures could enlarge?

Spleen

Rick Ellerston, a 42-year-old ironworker, is a client in the diagnostic center where you practice nursing. In your education regarding his upcoming testing, you discuss the role of lymphatic fluid and its circulation. What is the primary mechanism of lymphatic fluid circulation?

Skeletal muscle contraction

Clinical assessment of a patient with AML includes observing for signs of infection, the major cause of death for AML. The nurse should assess for indicators of:

Splenomegaly