A home health nurse is caring for a client with multiple myeloma. What intervention should the nurse prioritize when addressing the client's severe bone pain?

Teaching the client to use NSAIDs effectively

Helping the client manage the opioid analgesic regimen

Implementing distraction techniques

Educating the client about the effective use of hot and cold packs

Answer and Explanation

The Correct Answer is B

A. Teaching the client to use NSAIDs effectively: While NSAIDs can be used for mild to moderate pain, they are not the first choice for severe bone pain, especially in conditions like multiple myeloma. NSAIDs can also have adverse effects on kidney function, particularly in clients with compromised renal function, common in multiple myeloma.

B. Helping the client manage the opioid analgesic regimen: Severe bone pain in multiple myeloma is often best managed with opioids due to the intensity of the pain. The nurse should prioritize ensuring the client is using the opioid analgesic regimen effectively and safely to control the pain while minimizing side effects and risk of addiction.

C. Implementing distraction techniques: Distraction techniques can help with mild to moderate pain, but they are not sufficient for managing severe pain from conditions like multiple myeloma. Pharmacologic pain management is more appropriate for severe pain.

D. Educating the client about the effective use of hot and cold packs: Hot and cold packs can provide temporary relief for some types of pain, but they are not sufficient for managing the severe bone pain associated with multiple myeloma. Pharmacologic management is the priority intervention.

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Correct Answer is B

Explanation

A. "I understand what you mean, you can never be sure if the blood is tainted." This response would be inappropriate as it may increase the patient's anxiety and perpetuate fear about the transfusion. It does not provide accurate information about the safety of blood transfusions.

B. "I understand your concern. The blood is screened very carefully for different viruses as well as HIV." This response acknowledges the patient's concern while providing accurate and reassuring information. Blood donations are rigorously screened for HIV and other infectious diseases to ensure safety.

C. "If you don't have the blood transfusions, you may not make it through this episode of bleeding." While this statement is true, it focuses on the negative consequence without addressing the patient's fear. It also lacks a supportive and informative approach to the patient's concern about HIV.

D. "No one has gotten HIV from blood in a long time. You have to have the transfusion." This is dismissive and does not adequately address the patient's concern or provide accurate information about the safety measures in place for blood transfusions. It also pressures the patient into a decision without educating them.

A. Age 19 to 30 years B. Dark hair C. History of chronic skin irritation D. Female gender

Correct Answer is C

Explanation

A. Age 19 to 30 years: While malignant melanoma can occur at any age, it is more commonly diagnosed in individuals aged 30 to 40 years or older. Being in the 19-30 age group does not significantly increase the risk of developing melanoma.

B. Dark hair: Dark hair is not a major risk factor for malignant melanoma. In fact, individuals with lighter skin and hair are generally at a higher risk. Hair color alone does not place a person at high risk for melanoma.

C. History of chronic skin irritation: Chronic skin irritation or conditions that cause repeated trauma to the skin can increase the risk of melanoma. This includes a history of sunburns or other forms of skin damage, which can predispose the skin to malignant changes over time.

D. Female gender: While gender can play a role in the risk of melanoma, it is not as significant as other factors like fair skin, history of sun exposure, or family history of melanoma. Both males and females can be affected by melanoma.

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A home health nurse is caring for a client with multiple myeloma. What intervention should the nurse prioritize when addressing the client's severe bone pain?

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