A nurse is caring for a 75.year.old male client who is experiencing difficulty breathing and shortness of breath.

Exhibits

The nurse is caring for the client following a thoracentesis. Select the 3 findings that require immediate follow.up.

A. Avoid crowds. Clients with neutropenia have a significantly increased risk of infection due to a reduced neutrophil count, which impairs the immune response. Avoiding crowds helps minimize exposure to pathogens, reducing the risk of opportunistic infections. Clients should also practice hand hygiene, wear a mask in public places, and avoid close contact with sick individuals.
B. Take temperature weekly. Clients with neutropenia should monitor their temperature at least once daily, not weekly. A fever (≥100.4°F or 38°C) may be the only early sign of infection, which requires immediate medical attention due to the risk of sepsis.
C. Perform mild exercise, such as gardening. While mild exercise can promote overall wellbeing, gardening poses an infection risk due to exposure to soil, which may contain fungi, bacteria, and other pathogens (e.g., Aspergillus species). Clients should avoid activities that increase the risk of infection.
D. Eat plenty of fresh fruits and vegetables. Raw or unwashed fruits and vegetables can harbor bacteria and fungi, increasing infection risk. Clients with neutropenia should consume fully cooked foods, avoid raw produce, and follow proper food handling practices to prevent foodborne illnesses.

A. Lower back or groin pain. Early signs of an abdominal aortic aneurysm (AAA) include deep, constant pain in the abdomen, lower back, or groin due to pressure on surrounding structures. The pain is often steady and not relieved by position changes. As the aneurysm expands, the risk of rupture increases, making early recognition critical.
B. Presence of Cullen’s sign. Cullen’s sign (periumbilical bruising) is associated with intraperitoneal hemorrhage, often due to pancreatitis or ruptured ectopic pregnancy rather than an early sign of an AAA. However, if the aneurysm ruptures, flank or periumbilical bruising (Grey Turner’s or Cullen’s sign) may appear as a late finding.
C. Hunger after eating. Abdominal aortic aneurysms do not affect hunger or digestion in early stages. However, compression of surrounding organs in larger aneurysms may lead to early satiety, nausea, or bowel changes, but this is not an early manifestation.
D. Pain in the chest. While thoracic aortic aneurysms can cause chest pain, an abdominal aortic aneurysm primarily causes abdominal, lower back, or flank pain due to its location below the diaphragm. Chest pain would be more concerning for a thoracic aortic aneurysm or acute aortic dissection rather than an AAA.