A nurse is preparing a client for radiation treatment who is postoperative following a mastectomy. The nurse should inform the client to expect which of the following adverse effects from the treatment?

Choice A: Encourage her to turn, cough, and deep breathe at frequent intervals. This intervention is appropriate for the nurse to include in the client's plan of care at this time because it can help prevent respiratory complications such as atelectasis (collapse of lung tissue) or pneumonia after surgery. Turning, coughing, and deep breathing can help expand the lungs, clear the airways, and improve oxygenation.

Choice B: Ask the client how she feels about having her breast removed. This intervention is not appropriate for the nurse to include in the client's plan of care at this time because it may be too intrusive or insensitive. Asking the client how she feels about having her breast removed may trigger emotional distress or anxiety in the client who has just undergone a major surgery that affects her body image and self-esteem. The nurse should wait until the client is more stable and ready to talk about her feelings and concerns.

Choice C: Attach a sign above her bed to have BP, IV lines, and lab work in her right arm. This intervention is not appropriate for the nurse to include in the client's plan of care at this time because it is incorrect and potentially harmful. Attaching a sign above her bed to have BP, IV lines, and lab work in her right arm may cause injury or infection to the arm that has undergone surgery and lymph node removal. The nurse should attach a sign above her bed to have BP, IV lines, and lab work in her left arm instead.

Choice D: Position her right arm below heart level. This intervention is not appropriate for the nurse to include in the client's plan of care at this time because it is incorrect and potentially harmful. Positioning her right arm below heart level may impair the blood circulation and lymphatic drainage of the arm that has undergone surgery and lymph node removal. The nurse should position her right arm above heart level instead.

Choice A: Breast milk is not the correct answer because it is not a route of transmission for syphilis. Syphilis is caused by a bacterium called Treponema pallidum, which cannot survive in breast milk. However, breastfeeding mothers with syphilis should be treated with antibiotics to prevent other complications.

Choice B: The birth canal is not the correct answer because it is not a route of transmission for syphilis. Syphilis can be transmitted through sexual contact, but not through vaginal delivery. However, pregnant women with syphilis should be screened and treated before delivery to prevent congenital syphilis in their newborns.

Choice C: Amniotic fluid is not the correct answer because it is not a route of transmission for syphilis. Syphilis cannot cross the amniotic membrane, which protects the fetus from infections in the uterus. However, pregnant women with syphilis should be monitored for signs of fetal distress or premature rupture of membranes.

Choice D: Placenta is the correct answer because it is a route of transmission for syphilis. Syphilis can cross the placenta, which connects the mother and the fetus through blood vessels. This can result in congenital syphilis, which can cause serious problems such as stillbirth, miscarriage, low birth weight, deformities, or neurological damage in newborns.