A clinic nurse is working with a client who has a long-standing diagnosis of polycythemia vera. How can the nurse best gauge the course of the client's disease?
Follow the trends of the client's hematocrit.
Document the color of the client's palms and face during each visit.
Document the client's response to erythropoietin injections.
Follow the client's erythrocyte sedimentation rate over time.
The Correct Answer is A
A. Follow the trends of the client's hematocrit: This is the most reliable way to gauge the course of polycythemia vera. The condition is characterized by an increase in red blood cell mass, and tracking changes in hematocrit levels helps assess disease progression and the effectiveness of treatment.
B. Document the color of the client's palms and face during each visit: While polycythemia vera can cause ruddy complexion due to increased red blood cell count, changes in the color of the palms and face are not a consistent or reliable indicator of disease progression. Hematocrit levels are more direct measures.
C. Document the client's response to erythropoietin injections: Erythropoietin is not used in the treatment of polycythemia vera because the disease involves excess RBC production. Primary treatment focuses on reducing RBC count rather than increasing it with erythropoietin.
D. Follow the client's erythrocyte sedimentation rate over time: The erythrocyte sedimentation rate (ESR) measures inflammation but does not specifically reflect the status of polycythemia vera. Hematocrit is a more direct and specific measure of the disease’s progression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "I will eat five or six small meals each day.": Eating smaller, more frequent meals is recommended for clients with chronic obstructive pulmonary disease (COPD). It helps prevent feeling too full and improves breathing during meals.
B. "I will take my bronchodilators after meals.": Bronchodilators should typically be taken before meals, not after. Taking bronchodilators before meals helps open the airways, making breathing easier during eating and improving oxygen intake.
C. "I will choose foods that are not gas-forming.": Gas-forming foods, such as beans and cruciferous vegetables, can cause bloating and discomfort, which can exacerbate breathing difficulties in clients with COPD.
D. "I will rest for at least 30 minutes before eating.": Resting before meals is helpful for conserving energy and preventing shortness of breath during eating. It is a good practice for clients with COPD, allowing them to breathe more comfortably while eating.
Correct Answer is B
Explanation
A. Attending a class given about tracheostomy care: Attending a class can provide valuable information, but it does not demonstrate that the partner is ready to perform suctioning independently. The partner needs to show hands-on competence in the procedure.
B. Performing the procedure independently: The ability to perform tracheostomy suctioning independently is the most important indicator that the partner is ready for the client's discharge. It shows the partner has the practical skills necessary for safe care at home.
C. Asking appropriate questions about suctioning: Asking questions is a sign of engagement and a willingness to learn, but it does not indicate mastery of the procedure. The partner needs to demonstrate competency in performing suctioning, not just asking about it.
D. Verbalizing all steps in the procedure: Verbalizing the steps is helpful but does not guarantee that the partner can perform the procedure safely. Hands-on practice and ability to execute the steps independently are necessary for readiness.
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