Lung Cancer/ Non-Hodgkin's Lymphoma (Prep U)

A nurse educator is reviewing the indications for chest drainage systems with a group of medical nurses. What indications should the nurses identify? Select all that apply. Post thoracotomy Spontaneous pneumothorax Need for postural drainage Chest trauma resulting in pneumothorax Pleurisy

Post thoracotomy Spontaneous pneumothorax Chest trauma resulting in pneumothorax Chest drainage systems are used in treatment of spontaneous pneumothorax and trauma resulting in pneumothorax. Postural drainage and pleurisy are not indications for use of a chest drainage system.

Following thoracic surgery, what should the nurse include in the care plan for a client at risk for impaired gas exchange? Select all that apply. Monitor vital signs frequently. Reinforce preoperative breathing exercises. Elevate head of bed 30 to 40 degrees as tolerated. Administer pain medications. Maintain accurate record of intravenous intake.

Monitor vital signs frequently. Reinforce preoperative breathing exercises. Elevate head of bed 30 to 40 degrees as tolerated. Administer pain medications. Nursing management for a client with the goal of maintaining optimal gas exchange includes assessing vital signs frequently; reinforcing preoperative instructions about deep breathing, coughing, and incentive spirometry; and elevating the head of the bed as tolerated. Administering pain medications may help the client with breathing exercises. Accurate record of intravenous fluids is a nurse action, but not a client care issue.

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 When assessing a client with a disorder of the hematopoietic or the lymphatic system, it is essential to assess the client's health history. An assessment of drug history is essential because some antibiotics and cancer drugs contribute to hematopoietic dysfunction. Aspirin and anticoagulants may contribute to bleeding and interfere with clot formation. Because industrial materials, environmental toxins, and household products may affect blood-forming organs, the nurse needs to explore exposure to these agents. Age, gender, menstrual history, or lifestyle assessments, such as exercise routines and habits, do not directly affect the hematopoietic or lymphatic system.

Which type of lung cancer is characterized as fast growing and tends to arise peripherally?

Large cell carcinoma Large cell carcinoma is a fast-growing tumor that tends to arise peripherally. Bronchoalveolar cell cancer arises from the terminal bronchus and alveoli and usually grows slowly. Adenocarcinoma presents as peripheral masses or nodules and often metastasizes. Squamous cell carcinoma arises from the bronchial epithelium and is more centrally located.

Which type of lung cancer is the most prevalent among both men and women?

Adenocarcinoma Adenocarcinoma is most prevalent in both men and women and presents more peripherally as masses or nodules and often metastasizes. Large cell carcinoma is a fast-growing tumor that tends to arise peripherally. Squamous cell carcinoma is more centrally located and arises more commonly in the segmental and subsegmental bronchi in response to repetitive carcinogenic exposure. Small cell carcinomas arise primarily as proximal lesions, but may arise in any part of the tracheobronchial tree.

The nurse is caring for a client receiving treatment for non-Hodgkin lymphoma (NHL). Which assessment findings indicate to the nurse that the client is developing multifocal leukoencephalopathy? Select all that apply. Altered vision Change in speech Facial nerve paralysis Change in motor coordination Peripheral neuropathy

Altered vision Change in speech Change in motor coordination The goal of treatment for NHL is to obtain remission of disease by killing as many of the malignant cells as possible. A rare but potentially life-threatening complication is progressive multifocal leukoencephalopathy which may occur in clients with NHL who are severely immunocompromised and treated with chemotherapeutic agents. Symptoms of this complication include confusion, altered vision, change in speech, and a change in motor coordination. Facial nerve paralysis and peripheral neuropathy are not symptoms of this complication.

A client with Hodgkin lymphoma is receiving information from the oncology nurse. The client asks the nurse why it is necessary to stop drinking and smoking and stay out of the sun. Which response by the nurse would be best?

"It's important to reduce other factors that increase the risk of second cancers." The nurse should encourage clients to reduce other factors that increase the risk of developing second cancers, such as use of tobacco and alcohol and exposure to environmental carcinogens and excessive sunlight. The presence of Reed-Sternberg cells is the pathologic hallmark and essential diagnostic criterion for Hodgkin lymphoma, so avoiding these behaviors will not reduce the risk of Reed-Sternberg cells developing. There is no evidence that these behaviors will reduce the effectiveness of chemotherapy or increase the risk of hemorrhage, which is not a typical complication of Hodgkin lymphoma.

For a client with Hodgkin lymphoma, who is at a risk for ineffective airway clearance and impaired gas exchange, the nurse places the client in a high Fowler's position to

increase lung expansion. For a client with Hodgkin disease who is at a risk for ineffective airway clearance and impaired gas exchange, the nurse keeps the neck in the midline and places the client in a high Fowler's position if respiratory distress develops. Avoiding unnecessary pressure on the trachea and positioning for increased lung expansion improve air exchange. The nurse administers oxygen, per the physician's orders, to reduce deficits in the blood oxygen concentration. The nurse assesses the client's respiratory status during each shift to detect compromised ventilation. The nurse places an endotracheal tube, a laryngoscope, and a bag-valve mask at the bedside for intubation if the need for the airway management arises.