A nurse is caring for a client who is being tested for chronic myelogenous leukemia (CML). Which of the following diagnostic tests should the nurse anticipate being prescribed?(Select All that Apply.)

A. A white blood cell (WBC) count of 8,000/mm³ is within the normal range (typically 4,000- 11,000/mm³). This value does not indicate any immediate concern and does not need to be reported to the provider.
B. A PTT of 65 seconds is elevated, as the therapeutic range for PTT when on heparin is typically 1.5 to
2.5 times the normal range (usually around 25-35 seconds). An elevated PTT increases the risk of bleeding, and this should be reported to the provider for potential adjustment of heparin dosage or further evaluation.
C. A hematocrit of 45% is within the normal range for adult females (typically around 37-47%) and males (around 42-52%). This value does not indicate a concern that needs reporting to the provider.
D. A platelet count of 74,000/mm³ is low (thrombocytopenia), as the normal range is typically 150,000- 450,000/mm³. This finding is significant, especially in the context of heparin therapy, as low platelet counts can increase the risk of bleeding.

A. While maintaining oral hygiene is important, excessive flossing, especially in a client receiving chemotherapy, may increase the risk of gum bleeding due to potential thrombocytopenia (low platelet count). Instead, gentle oral care is recommended to prevent irritation and bleeding.
B. Chemotherapy can cause nausea and vomiting, and administering an antiemetic before treatment can help prevent these side effects. It is a standard practice to improve the client's comfort and adherence to treatment.
C. This action may not be advisable, particularly if the mouthwash contains alcohol or strong antiseptics, which can irritate mucous membranes, especially in clients undergoing chemotherapy. Instead, using a mild, alcohol-free mouthwash or a saline solution may be more appropriate for maintaining oral hygiene without causing irritation.
D. This statement is not typically accurate for all chemotherapy regimens. While some medications (like iron supplements) can cause dark stools, chemotherapy can lead to various gastrointestinal side effects, including diarrhea or constipation, rather than specifically dark stools.