A nurse develops a delayed hypersensitivity reaction after wearing latex gloves. Which pathophysiologic process is involved in this type of hypersensitive reaction?

A. A 40-year-old client who smoked cigarettes as a teen. While smoking is a known risk factor for several cancers, a brief history of smoking in adolescence does not pose as high a risk as a strong family history of breast cancer. Long-term smoking exposure is more strongly linked to lung and other cancers.
B. A 50-year-old woman with a maternal history of breast cancer. A family history of breast cancer, especially in a first-degree relative (mother, sister, or daughter), significantly increases the risk of developing breast cancer. This client may also carry genetic mutations such as BRCA1 or BRCA2, further elevating the risk.
C. A woman who had a total hysterectomy 5 years ago for a grade 4 Pap smear. A grade 4 Pap smear indicates severe cervical dysplasia or carcinoma in situ, but a total hysterectomy removes the uterus and cervix, significantly reducing the risk of cervical cancer recurrence.
D. A man with no tumor marker elevation 3 years after prostate cancer treatment. This client is in remission with no current signs of active cancer. While prostate cancer survivors require monitoring, his risk is lower compared to someone with an active familial predisposition to cancer.

A. Peripheral neurovascular dysfunction. While some chemotherapy agents can cause neuropathy, the immediate risk of a vesicant (a drug that can cause severe tissue damage if it leaks) is extravasation, leading to skin and tissue damage, rather than direct neurovascular impairment.
B. Impaired skin integrity. Vesicants can cause severe tissue necrosis if they extravasate (leak into surrounding tissues). Leaving an IV in place for 72 hours increases the risk of infiltration or extravasation, which can lead to serious complications, including blistering, necrosis, and deep tissue injury. Proper IV site rotation and monitoring are essential to prevent skin and tissue damage.
C. Fluid volume excess. Fluid volume excess is not a direct risk related to vesicant chemotherapy. While some IV fluids can contribute to fluid overload, the primary concern with vesicants is extravasation and tissue damage.
D. Acute pain and anxiety. While pain and anxiety can occur if extravasation happens, the greatest clinical risk is the physical damage caused by tissue necrosis. Pain is a symptom of extravasation, but preventing skin and tissue injury is the priority.