A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching?

A. Fever and cardiac dysrhythmias are not specific complications of tissue plasminogen activator (t-PA) therapy. While they can occur after a stroke or as a general response to illness, they are not the primary indicators of complications related to thrombolytic therapy.

B. An elevated blood pressure combined with a headache could indicate a hemorrhagic transformation, which is a serious complication after t-PA administration. Thrombolytic therapy increases the risk of bleeding, and these symptoms may signal intracranial hemorrhage.

C. A positive Babinski's sign (extensor plantar response) is often seen in stroke patients as a neurological finding, but it is not specifically an indication of a complication from t-PA therapy. It is more reflective of the brain injury or stroke itself rather than the medication.

D. Nausea and vomiting can be signs of increased intracranial pressure (ICP), which could result from hemorrhage following t-PA therapy. This is a critical sign that requires immediate evaluation to rule out complications such as bleeding.

E. A decreased level of consciousness is a significant red flag and may indicate cerebral hemorrhage or another serious complication related to the administration of t-PA. Monitoring for changes in neurological status is crucial following thrombolytic therapy.

A. Renal impairment is not a common complication directly associated with radiation therapy for esophageal cancer. Radiation typically affects the targeted area and surrounding tissues, not the kidneys.
B. A profound feeling of tiredness (fatigue) is a common side effect of radiation therapy, as it affects the body's energy levels, but it is generally expected and not necessarily a sign of a complication.
C. Weight loss is a common symptom of esophageal cancer itself due to difficulty swallowing and poor nutrition, as well as a side effect of radiation therapy. However, it is not necessarily an indication of a complication but rather a normal symptom of the disease and its treatment.
D. Radiation therapy can cause bone marrow suppression, which impacts the production of blood cells. This is a serious complication and can lead to anemia, leukopenia, or thrombocytopenia, increasing the risk of infections, bleeding, and fatigue. Therefore, development of bone marrow suppression would be a critical finding to address.