A nurse is caring for a client who is receiving cisplatin for the treatment of ovarian cancer. The client's most recent complete blood count (CBC) is shown in the table below. It is important for the nurse to consider which of the following for the client?
- WBC: 1,400/mm³
- RBC: 4.3 x 10¹²/L
- Hgb: 12.1 g/dL
- Hct: 36.5%
- Platelets: 170,000/mm³
- Albumin: 4.5 g/dL
Given the options:
The client should receive an erythropoiesis-stimulating agent.
The client should receive a diet with increased protein.
The client has an increased risk of infection.
The client has an increased risk for bleeding.
The Correct Answer is C
Choice A reason: The use of erythropoiesis-stimulating agents (ESAs) is indicated for anemia due to chemotherapy¹. However, the client's hemoglobin (Hgb) level is 12.1 g/dL, which is within the normal range (normal: 12-15.5 g/dL for women). Therefore, administering an ESA is not indicated based on the Hgb level provided.
Choice B reason: A diet with increased protein can be beneficial for patients undergoing chemotherapy as it helps in tissue repair and immune system function. However, the client's albumin level is 4.5 g/dL, which falls within the normal range (normal: 3.4-5.4 g/dL), suggesting adequate protein intake. Thus, there is no indication that the client requires an increased protein diet based on the albumin level provided.
Choice C reason: The client's white blood cell (WBC) count is 1,400/mm³, which is below the normal range (normal: 4,500-11,000/mm³). This condition, known as leukopenia, significantly increases the risk of infection³. Therefore, the nurse should prioritize monitoring for signs of infection and implementing infection control measures.
Choice D reason: The client's platelet count is 170,000/mm³, which is within the normal range (normal: 150,000-450,000/mm³). Although cisplatin can cause thrombocytopenia, the current platelet count does not indicate an increased risk for bleeding⁴. Therefore, this choice is not correct based on the platelet count provided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason:
Restricting the client's oral fluid intake is not typically recommended as part of postoperative care following TURP. In fact, maintaining adequate hydration is important to help flush the bladder and prevent clot formation.
Choice B reason:
It is common for clients to feel a constant urge to void due to the irritation of the bladder from the catheter and the continuous bladder irrigation. Reminding the client that this sensation is normal and expected can help alleviate anxiety and provide reassurance.
Choice C reason:
Monitoring the client's urine output is important to ensure that the bladder irrigation is effective and that there are no signs of obstruction. However, it should be done more frequently than every 6 hours, especially in the immediate postoperative period, to promptly detect any complications.
Choice D reason:
Weighing the client every evening is not directly related to the management of continuous bladder irrigation. While monitoring weight can be part of overall postoperative care, it does not address the specific needs related to TURP and continuous bladder irrigation.
Correct Answer is A
Explanation
Choice A reason:
The statement about eating a high fiber diet reducing the risk for developing skin cancer is misleading. While a high fiber diet has many health benefits, there is no direct evidence that it significantly reduces the risk of skin cancer. Skin cancer prevention primarily focuses on protecting the skin from excessive sun exposure and avoiding ultraviolet (UV) light sources.
Choice B reason:
Avoiding the use of tanning booths is correct advice. Tanning booths emit UV radiation, which can increase the risk of skin cancer, including melanoma, the deadliest form of skin cancer. The use of tanning beds is strongly discouraged by health professionals.
Choice C reason:
Using sunscreen even on cloudy days is also correct. UV rays can penetrate through clouds, and sun protection is necessary regardless of the weather to reduce the risk of skin cancer. Sunscreen should be applied to all exposed skin and reapplied regularly, especially after swimming or sweating.
Choice D reason:
Checking the skin monthly for any changes is an important part of skin cancer prevention. Early detection of changes in moles or new skin growths can lead to early diagnosis and treatment, which is crucial for a better prognosis. This practice should be encouraged as part of routine self-care.
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