A nurse is providing teaching to a client who has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer. Which of the following instructions should the nurse include in the teaching?

Choice A reason:
Generalized urticaria, or hives, is not a common side effect of radiation therapy for lung cancer. While skin reactions can occur, they are usually localized to the area being treated. Urticaria might be a sign of an allergic reaction, which would require immediate attention, but it is not typically associated with radiation therapy¹.

Choice B reason:
Xerostomia, or dry mouth, is a common side effect of radiation therapy, especially when the radiation field includes salivary glands. For lung cancer patients, if the radiation field is near the neck or upper chest, it could potentially affect salivary gland function. Monitoring for xerostomia is important because it can lead to difficulties in speaking, eating, and swallowing, and it increases the risk for dental problems².

Choice C reason:
While reviewing laboratory test results for low hemoglobin is an important part of nursing care, it is not specific to radiation therapy for lung cancer. Low hemoglobin could be related to the cancer itself or a side effect of other treatments like chemotherapy. It is important to monitor, but not the primary action related to radiation therapy³.

Choice D reason:
Observing for signs of infection is a general nursing responsibility for all patients, not specific to those receiving radiation therapy for lung cancer. However, if the patient's immune system is compromised due to the cancer or other treatments, vigilance for infection is heightened.

Choice A reason:
Activities that could result in bleeding should be minimized for a client with neutropenia due to the increased risk of infection from open wounds. However, this is not the primary restriction related to neutropenia itself but rather a general precaution for patients with low platelet counts or other clotting issues.

Choice B reason:
Restricting all visitors from entering the client's room is not necessary unless the visitors are sick or have been exposed to infectious diseases. Neutropenic patients are at increased risk for infection, so visitors should be screened for illness, but complete isolation is not required.

Choice C reason:
Modifying oral fluid intake to between meals only is not a standard restriction for neutropenic patients. Adequate hydration is essential, and there are no specific neutropenia-related reasons to restrict fluids to between meals.

Choice D reason:
Fresh flowers and potted plants should be avoided in the room of a neutropenic patient. They can harbor fungi and other microorganisms that could cause infection in an immunocompromised individual. Neutropenic precautions typically include avoiding standing water and plants that may contain harmful bacteria or fungi.