A nurse is planning care for a client who has leukemia and a platelet count of 130,000/mm3. Which of the following interventions should the nurse include in the plan of care?

Check the IV site for bleeding every 8 hr

Obtain a rectal temperature every 8 hr.

Check the client for proteinuria.

Limit, IM injections.

Answer and Explanation

The Correct Answer is D

A. Checking the IV site for bleeding is important for clients with low platelet counts, but it should be monitored more frequently, ideally every 1-2 hours.
B. Obtaining a rectal temperature is routine nursing care but does not specifically address the risk associated with the client's platelet count.
C. Checking for proteinuria may be relevant in other conditions but is not directly related to the client's current hematologic condition.
D. Limiting IM injections is crucial in clients with leukemia and low platelet counts to prevent bleeding complications from puncture sites.

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Correct Answer is C

Explanation

A. WBCs (White Blood Cells) may be decreased in multiple myeloma due to bone marrow suppression.
B. ANC (Absolute Neutrophil Count) can be decreased due to bone marrow suppression from the disease or treatment.
C. Calcium levels are often elevated in multiple myeloma due to bone breakdown and release of calcium from bone.
D. Platelets may be decreased due to bone marrow suppression as well.

A. A client who has a simple fracture of the femur, multiple scratches on both legs, and is crying hysterically B. A client who has severe head injuries, respiratory rate 6/min, and is unresponsive C. A client who has a piece of wood punctured into the chest wall and has an audible hissing sound coming from the wound site D. A female who is pregnant at 20 weeks of gestation, has multiple cuts and abrasions, and is walking around

Correct Answer is C

Explanation

A. While painful, a simple fracture and scratches do not pose an immediate threat to life compared to other injuries.
B. The client with severe head injuries and a low respiratory rate may seem like a priority, but if they are unresponsive and have a respiratory rate as low as 6/min, they may be beyond help.
C. A punctured chest with an audible hissing sound indicates a potential tension pneumothorax, a life-threatening condition that requires immediate intervention to prevent collapse of the lung and other potentially fatal complications.
D. A pregnant woman with cuts and abrasions should be evaluated promptly but is not as critical as clients with severe head injuries or tension pneumothorax.

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A nurse is planning care for a client who has leukemia and a platelet count of 130,000/mm3. Which of the following interventions should the nurse include in the plan of care?

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