A client, who is receiving intravenous chemotherapy into a peripheral vein, says that the arm burns terribly in and around the intravenous site. What is the nurse's best first action?

Slow the rate of infusion

Apply a warm compress to the site

Discontinue the infusion

Check for blood return

Answer and Explanation

The Correct Answer is C

A. Slowing the rate of infusion may provide some temporary relief, but it does not address the underlying issue and may worsen the situation.
B. Applying a warm compress may soothe discomfort but is not the priority action when a burning sensation is reported, which could indicate potential extravasation.
C. Discontinuing the infusion is the best first action to prevent further damage to the tissue and to assess for complications such as infiltration or extravasation.
D. Checking for blood return can help assess the patency of the IV line, but the priority is to stop the infusion immediately to prevent complications.

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Correct Answer is C

Explanation

A. Applying pressure to injection sites helps reduce bleeding but does not directly prevent tumor lysis syndrome.
B. Monitoring telemetry is important for patients with potential cardiac issues but is not specifically related to preventing complications from tumor lysis syndrome.
C. Ensuring a high fluid intake of 3000 to 5000 mL/day helps dilute electrolytes and reduce the risk of acute kidney injury and other complications associated with tumor lysis syndrome, making this the most crucial intervention.
D. Assisting the client in ambulatory activities may support their overall well-being but does not address the prevention of tumor lysis syndrome.

A. Avoid high-protein food because they are irritating. B. Avoid snacking in between meal times. C. Maintain diet of pureed foods. D. Lie flat after meals to prevent vomiting.

Correct Answer is B

Explanation

A. High-protein foods are not typically irritating after an esophagogastrectomy and are essential for healing and maintaining nutritional status. Clients should be encouraged to eat balanced meals with adequate protein.
B. Clients recovering from an esophagogastrectomy should avoid snacking between meals to prevent dumping syndrome, a common complication where food moves too quickly from the stomach to the small intestine. Instead, small, frequent meals should be consumed.
C. While pureed foods may be part of the immediate post-operative diet, the long-term goal is to gradually reintroduce solid foods, following the physician's dietary recommendations. A pureed diet is not necessarily required long-term.
D. Lying flat after meals increases the risk of reflux, which can be particularly harmful to clients recovering from esophageal surgery. Clients should be advised to stay upright after eating to aid digestion and prevent reflux.

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A client, who is receiving intravenous chemotherapy into a peripheral vein, says that the arm burns terribly in and around the intravenous site. What is the nurse's best first action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which intervention is most important for the nurse to implement to prevent complications from tumor lysis syndrome during chemotherapy?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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