A 49-year-old female patient receives 3% NaCl solution for the correction of hyponatremia. Which assessment is most important for the nurse to monitor while the patient is receiving this infusion?

Choice A reason:

Offering peppermint aromatherapy during and after chemotherapy can be an effective non-pharmacological intervention for managing chemotherapy-induced nausea and vomiting (CINV). Aromatherapy with peppermint oil has been shown to reduce nausea and improve comfort in patients undergoing chemotherapy. The scent of peppermint can have a calming effect on the gastrointestinal system, helping to alleviate nausea. This intervention is easy to implement and can be used alongside other treatments to enhance patient comfort.

Choice B reason:

Administering antiemetics before chemotherapy is a standard practice for preventing CINV. Antiemetics, such as 5-HT3 receptor antagonists (e.g., ondansetron), NK1 receptor antagonists (e.g., aprepitant), and corticosteroids (e.g., dexamethasone), are commonly used to prevent nausea and vomiting associated with chemotherapy. These medications are most effective when given prophylactically, before the onset of symptoms. Administering antiemetics before chemotherapy helps to block the pathways that trigger nausea and vomiting, providing better control over these symptoms.

Choice C reason:

Keeping Ms. Anderson NPO (nothing by mouth) for the duration of the chemotherapy is not recommended for managing CINV. Keeping patients NPO can lead to dehydration and malnutrition, which can worsen their overall condition. Instead, patients should be encouraged to eat small, frequent meals and stay hydrated to maintain their strength and well-being. Proper nutrition and hydration are essential for supporting the body’s ability to tolerate chemotherapy and recover from its side effects.

Choice D reason:

Encouraging the patient to eat and drink when not nauseated is an important strategy for managing CINV. Eating small, frequent meals and staying hydrated can help maintain energy levels and prevent dehydration. Patients should be advised to eat bland, easy-to-digest foods and avoid foods that are greasy, spicy, or have strong odors, as these can exacerbate nausea. Encouraging patients to eat and drink when they feel well can help them maintain their nutritional status and improve their overall tolerance to chemotherapy.

Choice E reason:

Offering small sips of ginger ale can help manage nausea. Ginger has natural antiemetic properties and can be effective in reducing nausea and vomiting. Ginger ale, ginger tea, or ginger candies can be soothing and help settle the stomach. This simple intervention can be easily incorporated into the patient’s routine and can provide relief from mild to moderate nausea.

Choice F reason:

Encouraging Ms. Anderson to eat a high-protein meal prior to the chemotherapy infusion is not typically recommended for managing CINV. High-protein meals can be harder to digest and may increase the risk of nausea. Instead, patients should be advised to eat light, bland meals before chemotherapy to minimize the risk of nausea and vomiting. Light meals are easier on the stomach and less likely to trigger gastrointestinal discomfort.

Choice A Reason:
Monitoring the CXR (chest X-ray) results is not directly related to assessing myelosuppression. A chest X-ray is typically used to evaluate the lungs and heart, and while it can help identify infections or other complications, it does not provide information about bone marrow activity or blood cell counts. Myelosuppression specifically affects the production of blood cells in the bone marrow, which is best assessed through blood tests like the CBC (Complete Blood Count).
Choice B Reason:
Monitoring the BMP (Basic Metabolic Panel), especially the sodium, potassium, and magnesium counts, is important for evaluating electrolyte balance and kidney function. However, it does not directly assess myelosuppression. Myelosuppression involves the suppression of bone marrow activity, leading to decreased production of blood cells, which is not reflected in electrolyte levels.
Choice C Reason:
Monitoring the CBC (Complete Blood Count), especially the neutrophil, platelet, and RBC (red blood cell) counts, is the most appropriate method for assessing myelosuppression. Myelosuppression results in decreased production of blood cells, including neutrophils (a type of white blood cell), platelets, and red blood cells. A CBC provides detailed information about these cell counts and helps identify conditions like neutropenia (low neutrophil count), thrombocytopenia (low platelet count), and anemia (low red blood cell count), which are common consequences of myelosuppression.
Choice D Reason:
Monitoring the spinal fluid analysis is not relevant for assessing myelosuppression. Spinal fluid analysis is typically used to diagnose conditions affecting the central nervous system, such as infections, bleeding, or multiple sclerosis. It does not provide information about bone marrow activity or blood cell counts, which are the primary concerns in myelosuppression.