A nurse is assessing a client for superior vena cava syndrome.
Which finding is most concerning?

Choice A rationale

Encouraging bed rest without a thorough assessment could exacerbate complications, as prolonged immobility can lead to muscle atrophy, deep vein thrombosis, and pressure injuries. While rest may be part of a care plan, it is not the initial priority when a serious neurological complication is suspected.

Choice B rationale

Recommending increased physical activity without a definitive diagnosis or understanding of the cause of the back pain could be detrimental. If the pain is due to spinal cord compression, physical activity could worsen the compression, leading to irreversible neurological damage and further compromising mobility.

Choice C rationale

Prostate cancer frequently metastasizes to bone, particularly the spine. New-onset back pain in this context raises immediate concern for spinal cord compression, a oncologic emergency. Prompt assessment is crucial to identify neurological deficits, which, if untreated, can lead to permanent paralysis due to nerve damage.

Choice D rationale

While pain medication is important for comfort, it addresses the symptom without identifying the underlying cause. Administering analgesics without assessing for spinal cord compression could mask critical neurological signs, delaying necessary intervention and potentially leading to irreversible neurological deficits and worsening patient outcomes.

Choice A rationale

Suggesting the client avoid eating until hungry is generally not the best intervention for chemotherapy-induced nausea and loss of appetite. Prolonged fasting can worsen malnutrition, lead to energy deficits, and potentially exacerbate nausea due to an empty stomach, hindering recovery and treatment tolerance.

Choice B rationale

Encouraging the client to eat three large meals per day is often counterproductive during chemotherapy when nausea and appetite loss are prevalent. Large meals can overwhelm the digestive system, increase feelings of fullness, and trigger or worsen nausea and vomiting, leading to reduced intake.

Choice C rationale

Advising the client to increase their intake of fatty foods is generally not recommended for chemotherapy-induced nausea. Fatty foods are more difficult to digest, can delay gastric emptying, and are more likely to exacerbate nausea, bloating, and discomfort in a compromised digestive system.

Choice D rationale

Offering small, frequent meals that are easy to digest is the most effective intervention. This approach minimizes gastric distention, reduces the likelihood of triggering nausea, and allows for consistent nutrient intake. Easily digestible foods like crackers, toast, and clear broths are preferred, maintaining hydration.