A nurse discusses the self-care guidelines to minimize the side effects of radiation on the skin. Which self-care instructions can the nurse provide the client receiving radiation? [Select all that apply.]

Use a razor to shave the hair in the treated area.

Wash treated area gently with lukewarm water and mild soap.

Purchase aloe approved skin-care products

Wear loose-fitting, soft clothing over the treated skin.

Sun tan the affected area for no more than 30 minutes a day

Answer and Explanation

Correct Answer : B,C,D

A) Use a razor to shave the hair in the treated area:
Shaving the treated area with a razor is not recommended during radiation therapy. The skin in the treated area becomes sensitive and fragile, so shaving could cause irritation, cuts, or abrasions. Instead, clients are usually advised to use electric razors or avoid shaving the area altogether. This instruction should not be followed to minimize the risk of injury.

B) Wash treated area gently with lukewarm water and mild soap:
This is a key self-care instruction for clients receiving radiation. Gentle cleansing with lukewarm water and mild soap helps to avoid further irritation to the skin, which can become dry and sensitive during radiation therapy. The treated area should not be scrubbed or rubbed, as this can cause damage to the skin, exacerbate dryness, or cause skin breakdown. This guideline is appropriate and should be followed.

C) Purchase aloe-approved skin-care products:
Using aloe vera or skin-care products approved for use during radiation therapy can help soothe and moisturize the skin, which often becomes dry, irritated, or sunburned from radiation. It is important to use products that are specifically designed for use during radiation to avoid any potential irritants or allergens. Aloe-based products or products recommended by the healthcare provider can provide relief and reduce side effects.

D) Wear loose-fitting, soft clothing over the treated skin:
Wearing loose-fitting, soft clothing is a crucial self-care recommendation for clients undergoing radiation. Tight or rough fabrics can irritate the sensitive skin, potentially leading to discomfort or skin breakdown. Soft fabrics like cotton are ideal, as they allow the skin to breathe and help avoid further friction or pressure on the treated area. This is an important aspect of skin protection during radiation therapy.

E) Sun tan the affected area for no more than 30 minutes a day:
Sun tanning or exposing the treated skin to direct sunlight is strictly forbidden during and after radiation therapy. The skin in the treated area is much more sensitive to UV radiation and can burn easily, even with minimal sun exposure. It can increase the risk of skin damage and delayed healing. The client should be advised to avoid direct sun exposure entirely and to wear protective clothing and sunscreen if they must be outdoors.

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Correct Answer is A

Explanation

A) Digoxin:
The client’s symptoms of confusion, vision disturbances (such as yellow halos around lights), and anorexia are all classic signs of digoxin toxicity. Digoxin, a cardiac glycoside, is commonly used in the treatment of heart failure and atrial fibrillation. However, it has a narrow therapeutic index, meaning that even slightly elevated blood levels can lead to toxicity. Other common symptoms of digoxin toxicity include bradycardia (which the client is also experiencing with a pulse of 53 bpm), nausea, and vomiting.

B) Diltiazem:
Diltiazem is a calcium channel blocker used to treat hypertension, angina, and atrial fibrillation. While it can cause bradycardia (as evidenced by the client’s pulse of 53 bpm), vision disturbances and anorexia are not typical side effects of this medication. More common side effects include hypotension, edema, and constipation.

C) Propranolol:
Propranolol is a beta-blocker used to treat hypertension, arrhythmias, and angina, as well as to prevent migraines. Bradycardia is a known side effect of beta-blockers, but vision disturbances and anorexia are not typical of propranolol. Moreover, propranolol can cause hypotension and fatigue but would not be as likely to cause the specific symptoms of confusion and vision changes seen in this client.

D) Captopril:
Captopril is an ACE inhibitor commonly used to treat hypertension and heart failure. Common side effects include hypotension, dizziness, and hyperkalemia, but vision disturbances and anorexia are not typical side effects of captopril. The symptoms the client is experiencing are more specific to digoxin toxicity than to captopril's side effects.

A. infuse lipoproteins to restore the myelin sheath. B. remove excess fluid from the blood stream. C. restore protein levels in the blood. D. remove circulating antibodies from the blood stream.

Correct Answer is D

Explanation

A) Infuse lipoproteins to restore the myelin sheath:
Multiple sclerosis (MS) is an autoimmune disease where the immune system attacks the myelin sheath around nerve fibers. Plasmapheresis does not work by infusing lipoproteins to restore the myelin sheath. The treatment's primary goal is to remove harmful substances from the blood that may be contributing to the autoimmune attack, particularly antibodies that target the nervous system, not by restoring the myelin itself.

B) Remove excess fluid from the bloodstream:
Plasmapheresis is a process used to remove certain substances from the plasma, including antibodies and immune complexes that might be exacerbating an autoimmune condition like MS. If the goal were to remove excess fluid, the treatment would be more akin to dialysis or a fluid management procedure, but this is not the case with plasmapheresis.

C) Restore protein levels in the blood:
While plasmapheresis can sometimes lead to a temporary decrease in protein levels due to the removal of plasma, this is not its primary purpose. The primary goal of plasmapheresis in the context of multiple sclerosis is to remove circulating antibodies and other immune-related substances.

D) Remove circulating antibodies from the bloodstream:
Plasmapheresis works by removing circulating antibodies from the bloodstream. In multiple sclerosis, the immune system mistakenly targets the myelin sheath, and plasmapheresis helps to remove the antibodies responsible for this autoimmune response. This can provide temporary relief of symptoms during acute flare-ups of MS by reducing the immune system's attack on the nervous system.

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A nurse discusses the self-care guidelines to minimize the side effects of radiation on the skin. Which self-care instructions can the nurse provide the client receiving radiation? [Select all that apply.]

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A client with a diagnosis of multiple sclerosis is scheduled to receive plasmapheresis treatments. A nurse explains to the client's spouse that the purpose of plasmapheresis is to:

Correct Answer is D

Explanation

A client with COPD exacerbation has been ordered oral prednisone to be tapered over two weeks. Which of the following side effects does the nurse recognize could occur during prednisone therapy? [Select all that apply.]

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