A nurse is providing care for a client who is receiving chemotherapy. Which of the following actions should the nurse take?

Wear gloves when handling the client's bed linens

Flush the client's urine down the toilet twice

Dispose of the client's intravenous tubing in a regular trash can

Wash the client's dishes with hot water and soap

Answer and Explanation

The Correct Answer is B

Choice A reason: Wearing gloves when handling the client's bed linens is an incorrect action, as it is not enough to protect the nurse from exposure to the chemotherapy agents. The nurse should wear gloves, gown, and mask when handling any body fluids or items contaminated with body fluids from the client.

Choice B reason: Flushing the client's urine down the toilet twice is a correct action, as it helps to prevent contamination of the environment and other people with the chemotherapy agents. The nurse should also instruct the client and the family to do the same for 48 hours after the chemotherapy administration.

Choice C reason: Disposing of the client's intravenous tubing in a regular trash can is an incorrect action, as it poses a risk of exposure to the chemotherapy agents for the nurse and other staff. The nurse should dispose of the client's intravenous tubing in a biohazard container that is labeled as chemotherapy waste.

Choice D reason: Washing the client's dishes with hot water and soap is an incorrect action, as it is not sufficient to remove the chemotherapy agents from the dishes. The nurse should use disposable dishes and utensils for the client, or wash them separately with bleach and water.

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Correct Answer is D

Explanation

Choice A reason: Inflammation noted on the tissue edges of a client's wound is a finding that indicates wound infection, not wound healing. The nurse should monitor the wound for signs of infection, such as increased pain, swelling, warmth, odor, or purulent drainage.

Choice B reason: Increase in serosanguineous exudate from a client's wound is a finding that indicates wound deterioration, not wound healing. The nurse should assess the wound for signs of increased tissue damage, such as bleeding, necrosis, or sloughing.

Choice C reason: Erythema on the skin surrounding a client's wound is a finding that indicates wound irritation, not wound healing. The nurse should evaluate the wound for signs of inflammation, such as redness, heat, or tenderness.

Choice D reason: Deep red color on the center of a client's wound is a finding that indicates wound healing, as it shows the presence of granulation tissue. Granulation tissue is a sign of new tissue growth and blood vessel formation, which are essential for wound healing.

A. Call the provider if you note clubbing of the client's fingernails. B. Have an assistive personnel ambulate the client just before meals. C. Notify me if you observe that the client has distended neck veins. D. Maintain the client's oxygen saturation level above 95 percent.

Correct Answer is C

Explanation

Choice A reason: Calling the provider if you note clubbing of the client's fingernails is not an instruction the charge nurse should include in the teaching. This is an unnecessary and inappropriate action, as clubbing is a chronic and irreversible sign of hypoxia that does not require immediate intervention. The nurse should document the finding and monitor the client's respiratory status.

Choice B reason: Having an assistive personnel ambulate the client just before meals is not an instruction the charge nurse should include in the teaching. This is a harmful and contraindicated action, as ambulation can increase the client's oxygen demand and cause dyspnea and fatigue. The nurse should schedule the client's activity and rest periods around the meals and provide supplemental oxygen as prescribed.

Choice C reason: Notifying the charge nurse if you observe that the client has distended neck veins is an instruction the charge nurse should include in the teaching. This is a necessary and appropriate action, as distended neck veins can indicate right-sided heart failure, which is a complication of COPD. The nurse should report the finding and assess the client for other signs of fluid overload, such as edema, weight gain, and crackles.

Choice D reason: Maintaining the client's oxygen saturation level above 95 percent is not an instruction the charge nurse should include in the teaching. This is an unrealistic and potentially harmful goal, as clients with COPD usually have lower oxygen saturation levels due to chronic hypoxia. The nurse should maintain the client's oxygen saturation level at the prescribed range, which is typically between 88 and 92 percent.

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