A nurse is contributing to the plan of care for a client who has bone marrow suppression related to chemotherapy treatments. Which of the following interventions should the nurse include in the plan?
Administer a saline enema for constipation.
Initiate contact precautions.
Encourage independence in the completion of ADLs.
Monitor oral mucosa daily.
The Correct Answer is D
A. Administer a saline enema for constipation. Administering a saline enema may be necessary for constipation, but it is not directly related to managing bone marrow suppression.
B. Initiate contact precautions. Contact precautions are typically used for infectious diseases. In clients with bone marrow suppression, neutropenic precautions are more appropriate to prevent infections.
C. Encourage independence in the completion of ADLs. While promoting independence is important, clients with bone marrow suppression may be fatigued or immunocompromised, requiring assistance to reduce infection risk and conserve energy.
D. Monitor oral mucosa daily. Monitoring oral mucosa daily is crucial because clients with bone marrow suppression are at risk for mucositis, which can lead to infection and impact nutrition and hydration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Drink adequate noncaffeinated and non-alcoholic beverages: Xerostomia (dry mouth) can be alleviated by staying hydrated with noncaffeinated and non-alcoholic beverages, which help to moisten the mouth and improve comfort.
B. Take nutrient-dense foods or to combine plant-based proteins: While nutrient-dense foods are important for overall health, they do not specifically address the issue of xerostomia. Plant-based proteins do not directly impact the symptoms of dry mouth.
C. Take protein-based liquid supplements: Protein-based liquid supplements are not specifically designed to address dry mouth and may not help in alleviating xerostomia.
D. Get dental care and practice dental hygiene daily: While dental care and hygiene are important for overall oral health, they do not specifically address xerostomia. Drinking fluids is more directly helpful for managing dry mouth.
Correct Answer is B
Explanation
A. Dental procedures: Fear of dental procedures is more indicative of a specific phobia, not social phobia.
B. Meeting strangers: Social phobia (social anxiety disorder) involves intense fear and anxiety in social situations where one might be judged, embarrassed, or scrutinized by others. Meeting strangers is a common fear for those with social phobia.
C. Being bitten by a dog: This is more consistent with a specific phobia related to animals, not social phobia.
D. Having a car accident: Fear of car accidents is not typically related to social phobia but could be linked to a specific or generalized anxiety disorder.
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