A nurse is assessing a client who has a long history of smoking and suspected of having laryngeal cancer. The nurse should anticipate that the client will report that her earliest manifestation was

A. Immunosuppressant medications are drugs that suppress or weaken the immune system. They are often prescribed to prevent rejection of transplanted organs or to treat autoimmune diseases. However, a weakened immune system makes individuals more susceptible to infections because their body's ability to fight off pathogens is compromised. Therefore, clients taking immunosuppressant medications have an increased risk of contracting communicable diseases.
B. Poor nutrition can weaken the immune system, making it less effective in defending against infections. Essential nutrients such as vitamins and minerals play crucial roles in immune function. A deficiency in these nutrients can impair immune responses, making individuals more vulnerable to communicable diseases.
C. Keeping immunizations up to date helps protect individuals from specific communicable diseases for which vaccines are available. Vaccines stimulate the immune system to produce antibodies against particular pathogens, providing immunity. Therefore, if immunizations are up to date, the client's risk of contracting certain communicable diseases is reduced.
D. Aging is associated with changes in the immune system, known as immunosenescence, which can weaken immune responses. Older adults may have decreased production of immune cells and antibodies, making them more susceptible to infections. Additionally, aging is often accompanied by chronic health conditions or medications that further compromise immune function, increasing the risk of communicable diseases.
E. Living in a nursing home or long-term care facility can increase the risk of exposure to communicable diseases due to close contact with other residents, sharing of common spaces, and potentially inadequate infection control practices. Older adults in nursing homes may also have multiple chronic conditions and weakened immune systems, further increasing their susceptibility to infections.

A. This response addresses the timeframe for heparin to achieve therapeutic levels in the bloodstream, not its action on dissolving clots. Heparin works primarily by inhibiting the formation of new clots and preventing existing clots from enlarging or propagating, rather than directly dissolving existing clots.
B. This statement accurately describes the mechanism of action of heparin. Heparin is an anticoagulant that works by enhancing the activity of antithrombin III, which inhibits the clotting factors thrombin and factor Xa. This action prevents the formation of new clots and stabilizes existing clots, but it does not actively dissolve them.
C. While pharmacists are knowledgeable about medications, including their mechanisms of action, it is within the scope of nursing practice to provide information on how medications work to clients. The nurse should be prepared to explain the basic mechanism of heparin's action to the client in understandable terms.
D. This response is inaccurate regarding heparin's action. Heparin itself does not directly dissolve clots; it prevents further clot formation and allows the body's natural fibrinolytic (clot-dissolving) mechanisms to work on existing clots. Oral medications like warfarin or direct oral anticoagulants (DOACs) may be used after initial heparin therapy to continue anticoagulation, but they do not directly dissolve clots either.