A nurse is caring for a female client who has toxic shock syndrome. Which of the following findings should the nurse expect?

Generalized rash

Elevated platelet count

Decreased total bilirubin

Hypertension

Answer and Explanation

The Correct Answer is A

A. Generalized rash is a common finding in toxic shock syndrome (TSS). The rash often appears as a sunburn-like rash and can progress to desquamation (peeling of the skin).

B. Elevated platelet count is not typically associated with toxic shock syndrome. In fact, thrombocytopenia (low platelet count) is more commonly seen in TSS.

C. Decreased total bilirubin is not associated with toxic shock syndrome. Bilirubin levels may be affected in cases of liver dysfunction, but TSS does not typically cause a decrease in bilirubin.

D. Hypertension is not a common finding in toxic shock syndrome. TSS often causes hypotension (low blood pressure) due to the systemic inflammatory response and shock.

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Correct Answer is C

Explanation

A. Soiled bed linens should not be kept in the client's room during brachytherapy due to the risk of contamination. They should be carefully handled and disposed of according to facility protocols.

B. The radioactive device should not be discarded in the trash. It needs to be handled and disposed of by trained personnel in a safe, controlled manner to prevent exposure to others.

C. Visitors should be instructed to maintain a safe distance (usually 6 feet, but 3 feet is sometimes acceptable) from the client during brachytherapy to minimize radiation exposure.

D. Limiting time for visitors to 2 hours per day is not a standard recommendation for brachytherapy. The focus should be on minimizing radiation exposure by limiting proximity to the client, not just limiting time spent.

A. "I should expect less than 25 mL of secretions per day in the drainage devices." B. "I will perform strength-building arm exercises using a 15-pound weight." C. "I will keep my left arm flexed at the elbow as much as possible." D. "I will have to wait 2 months before additional saline can be added to my breast expander."

Correct Answer is A

Explanation

A. Less than 25 mL of secretions per day in the drainage devices is an expected finding after surgery. The nurse should instruct the client to monitor the drainage and report if the output exceeds this amount, as it could indicate a complication.

B. Performing strength-building arm exercises using a 15-pound weight is not recommended immediately after surgery. The client should start with gentle range-of-motion exercises and gradually increase the intensity, but heavy weightlifting should be avoided in the early recovery period.

C. Keeping the left arm flexed at the elbow for prolonged periods is not recommended. The client should be encouraged to perform exercises to prevent stiffness and improve mobility in the affected arm, but excessive flexion can lead to contractures.

D. The client may begin the process of saline expansion in the breast expander soon after surgery, typically within a few weeks. Waiting 2 months may be too long, as expansion is often started earlier to avoid complications such as capsular contracture.

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A nurse is caring for a female client who has toxic shock syndrome. Which of the following findings should the nurse expect?

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