A nurse is teaching a female client who has a new prescription for transdermal sumatriptan to treat migraine headaches. Which of the following instructions should the nurse include?

Choice A reason:

The statement “I might experience harmless white patches in my mouth” could indicate the presence of oral thrush, a common fungal infection in immunocompromised individuals. However, this statement does not directly reflect an understanding of preventive measures or home care instructions for someone with immunodeficiency.

Choice B reason:

Expecting to have a mild, occasional fever is not a typical understanding of immunodeficiency care. While fevers can occur, they should not be considered normal or expected. Any fever in an immunocompromised person should be promptly evaluated by a healthcare provider as it could indicate an infection.

Choice C reason:

Avoiding people who have just received a live vaccine is a crucial preventive measure for individuals with immunodeficiency. Live vaccines contain a weakened form of the virus or bacteria, which can pose a risk to immunocompromised individuals. This statement shows an understanding of the need to avoid potential sources of infection.

Choice D reason:

Limiting the use of skin cream to once a week is not a standard recommendation for immunodeficiency care. Skin care is important, but the frequency of using skin cream should be based on individual needs and the type of cream used. This statement does not reflect a specific understanding of immunodeficiency management.

Choice A reason: A productive cough

A productive cough is not typically associated with an acute hemolytic reaction. This symptom is more commonly related to respiratory conditions such as infections or chronic obstructive pulmonary disease (COPD). Acute hemolytic reactions primarily involve symptoms related to the destruction of red blood cells and the immune response.

Choice B reason: Distended neck veins

Distended neck veins are usually a sign of congestive heart failure or fluid overload. While they can indicate a serious condition, they are not specific to acute hemolytic reactions. The primary symptoms of an acute hemolytic reaction involve the immune system’s response to incompatible blood transfusion.

Choice C reason: Client report of low back pain

Low back pain is a classic symptom of an acute hemolytic reaction. This pain is typically due to the kidneys’ response to the breakdown of red blood cells, which can lead to hemoglobinuria and renal damage. The immune system’s attack on the transfused red blood cells causes this reaction, making it a critical symptom to recognize.

Choice D reason: Client report of tinnitus

Tinnitus, or ringing in the ears, is not associated with acute hemolytic reactions. This symptom is more commonly related to auditory issues or side effects of certain medications. Acute hemolytic reactions involve symptoms such as fever, chills, back pain, and hemoglobinuria.