A nurse is reviewing the laboratory results of a client who has acute leukemia and received an aggressive chemotherapy treatment 10 days ago. Which of the following hematologic laboratory values should the nurse expect? (Select all that apply.)

Increased hemoglobin count

Decreased leukocyte count

Decreased platelet count

Decreased erythrocyte count

Increased platelet count

Answer and Explanation

Correct Answer : B,C,D

A.   Aggressive chemotherapy often leads to a decrease in red blood cell production due to the suppression of bone marrow activity. Therefore, we would expect a decreased hemoglobin count rather than an increased one.
B.   Chemotherapy targets rapidly dividing cells, which includes not only cancer cells but also normal cells in the bone marrow, leading to a decreased leukocyte (white blood cell) count. This condition is known as leukopenia and increases the risk of infections.
C.   Similar to leukocytes, platelet production is also affected by chemotherapy, resulting in a decreased platelet count (thrombocytopenia). This can lead to increased bleeding risk and bruising.
D.   Chemotherapy can cause a decrease in erythrocytes (red blood cells) due to its impact on the bone marrow. This is part of the broader condition known as anemia, which is common in patients undergoing aggressive cancer treatments.
E.   Following aggressive chemotherapy, we would not expect an increased platelet count. Instead, the count is typically decreased due to the effects of the treatment on the bone marrow.

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Correct Answer is C

Explanation

A. Occurs when the bladder becomes overfilled and leaks due to weak or damaged bladder muscles.
B. Occurs when urine leaks involuntarily during activities that increase abdominal pressure, such as coughing, laughing, or lifting.
C. This type of incontinence occurs when the bladder contracts involuntarily, often without warning. It's caused by damage to the nerves that control the bladder, resulting in loss of voluntary control.
D. Occurs when a person has a sudden, strong urge to urinate and cannot hold it in.

A. Have the client floss 4 times daily. B. Administer an antiemetic prior to the procedure. C. Have the client swish with commercial mouthwash before therapy. D. Tell the client to expect dark stools following chemotherapy.

Correct Answer is B

Explanation

A. While maintaining oral hygiene is important, excessive flossing, especially in a client receiving chemotherapy, may increase the risk of gum bleeding due to potential thrombocytopenia (low platelet count). Instead, gentle oral care is recommended to prevent irritation and bleeding.
B. Chemotherapy can cause nausea and vomiting, and administering an antiemetic before treatment can help prevent these side effects. It is a standard practice to improve the client's comfort and adherence to treatment.
C. This action may not be advisable, particularly if the mouthwash contains alcohol or strong antiseptics, which can irritate mucous membranes, especially in clients undergoing chemotherapy. Instead, using a mild, alcohol-free mouthwash or a saline solution may be more appropriate for maintaining oral hygiene without causing irritation.
D. This statement is not typically accurate for all chemotherapy regimens. While some medications (like iron supplements) can cause dark stools, chemotherapy can lead to various gastrointestinal side effects, including diarrhea or constipation, rather than specifically dark stools.

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A nurse is reviewing the laboratory results of a client who has acute leukemia and received an aggressive chemotherapy treatment 10 days ago. Which of the following hematologic laboratory values should the nurse expect? (Select all that apply.)

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