A client diagnosed with acute myelogenous leukemia (AML) develops a platelet count of 10,000 mm3 during chemotherapy treatment. What is an appropriate nursing intervention for this client, based on this finding?

Table 34.1 Review of Normal Ranges for Complete Blood Cell Counts (Adult)

Blood Cell

Normal Ranges

Red blood cells (mature, circulating)

Male: 451-6.01 million/mm3

Female: 4.01-5.51 million/mm3

Hemoglobin

Adult (15-64 yr)

Male 14-17.3 g/dL

Female 11.7-155 g/dL

Hematocrit

42%-52% in males

36% -48% in females

Reticulocytes

0.5% -2.5% of total RBC count

White blood cells (total)

4.5-11.1 10/mm3

Neutrophils

59%

Bands 3% Segs-56%

Eosinophils

2.7%

Basophils

0.5%

Lymphocytes

34%

Monocytes

4%

Platelets

150,000-450,000/mm3

Obtain a prescription for stool occult blood testing

Encourage intake of oral fluids to 3000 mL/day

Assess the temperature every four hours

Provide oral hygiene every two hours

Answer and Explanation

The Correct Answer is C

A.   This intervention can be appropriate since a very low platelet count increases the risk of bleeding, including gastrointestinal bleeding. However, this action alone does not directly address the immediate risks associated with the low platelet count.
B.   While hydration is important for overall health, this intervention does not specifically address the risks associated with a low platelet count. Additionally, excessive fluid intake may not be appropriate for all patients, especially if there are underlying kidney issues or fluid restrictions.
C.   Clients with AML and low platelet counts are at increased risk for infections and may develop febrile neutropenia. Monitoring temperature every four hours can help detect early signs of infection, allowing for timely intervention.
D.   While maintaining oral hygiene is important, especially in patients undergoing chemotherapy, this intervention may not be the most critical action based on the acute concern of a very low platelet count. However, it is important to note that patients with low platelet counts may also experience bleeding from the gums, making gentle oral care essential.

Nursing Test Bank

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Correct Answer is D

Explanation

A. While it's true that ulcers can be a serious complication of PAD and require careful management, exercise is generally encouraged in patients with PAD as long as it is safe and supervised. Patients should consult their healthcare provider about appropriate exercise, but not exercising altogether can worsen their condition.
B. Buying shoes in the afternoon is advisable because feet can swell throughout the day. It helps ensure a better fit and reduces the risk of blisters or skin breakdown, which is particularly important for clients with PAD.
C. This statement is generally correct, as dangling the legs can help improve circulation in some cases. Clients with PAD often experience relief when their legs are in a dependent position, as it may help increase blood flow to the extremities. However, they should also be encouraged to avoid prolonged periods of sitting.
D. This statement may indicate a misunderstanding. Compression stockings are typically used for venous issues rather than arterial diseases like PAD. In patients with PAD, wearing compression stockings may not be appropriate and could potentially compromise arterial blood flow.

A. Complaints of pain at the incision B. Increased blood pressure C. Decreased white blood cell count D. Presence of blood on the pillow behind the patient

Correct Answer is D

Explanation

A. While pain can occur post-operatively and may be a sign of complications, it is not a direct indicator of bleeding. Pain can result from normal healing, surgical trauma, or other complications, but by itself, it does not specifically point to bleeding at the surgical site.
B. An increased blood pressure might not necessarily indicate bleeding. In some cases, blood pressure may increase due to pain, anxiety, or other factors. However, a significant drop in blood pressure would be more indicative of bleeding, especially in conjunction with other symptoms.
C. A decreased white blood cell count (leukopenia) is not typically associated with bleeding at the surgical site. In fact, following surgery, one might expect the white blood cell count to be normal or slightly elevated due to the body’s response to surgery.
D. This finding is indicative of bleeding at the surgical site. Blood on the pillow would suggest that there is active bleeding that has escaped from the surgical site, which is a significant concern that requires immediate assessment and intervention.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male: 451-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-155 g/dL
Hematocrit	42%-52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 10/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with peripheral arterial disease. Which statement, by the client, indicates that they need additional teaching?

Correct Answer is D

Explanation

The nurse is assessing a post-op thyroidectomy patient for bleeding. Which finding would indicate bleeding at the surgical site?

Correct Answer is D

Explanation

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In educating clients about ovarian cancer, the nurse emphasizes death rates for ovarian cancer are high because:

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