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A nurse on an oncology unit is caring for a client.

Exhibits

Complete the following sentence by using the lists of options.

The nurse should recognize the client is most likely experiencing 

as evidenced by
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

  • Malabsorption syndrome: While steatorrhea indicates fat malabsorption, this diagnosis is too general. The client’s symptoms are more likely linked to recent pelvic radiation, making a treatment-induced etiology more probable. There is no evidence of chronic GI disease or a primary malabsorption disorder that predates cancer treatment.
  • Tumor lysis syndrome: Typically presents with hyperuricemia, hyperkalemia, and acute kidney injury due to rapid tumor breakdown, not GI symptoms. The client’s vital signs and urine output are stable, with no lab evidence of metabolic abnormalities or renal failure.
  • Radiation enteritis: Caused by radiation damage to the small bowel, common in pelvic cancer treatments like for endometrial cancer. Symptoms such as nausea, steatorrhea, abdominal pain, and anorexia strongly support this diagnosis, especially within a week of initiating radiation.
  • Steatorrhea : Fatty stools indicate impaired fat absorption due to inflammation of the intestinal lining, consistent with radiation-induced enteritis. This is a key symptom supporting a diagnosis related to intestinal damage from radiation.
  • Metallic taste: Common with chemotherapy but non-specific; it does not indicate the underlying cause of malabsorption or abdominal discomfort. While notable, it’s not as critical as steatorrhea for identifying radiation enteritis.
  • Constipation: The client reports two bowel movements today, so constipation is not present and contradicts the clinical picture. Steatorrhea, rather than absence of bowel movements, suggests increased motility or malabsorption.


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Related Questions

Correct Answer is D

Explanation

A. Place the client in semi-Fowler's position: Semi-Fowler’s position may provide some assistance with digestion and general comfort, but it is not optimal for reducing aspiration risk in clients with dysphagia. A more upright position high-Fowler's is preferred during meals to allow gravity to assist with safe swallowing and prevent food or liquid from entering the airway.
B. Encourage the client to drink a small amount of water after each bite: Encouraging the client to drink water between bites can increase the risk of aspiration. Thin liquids are particularly difficult to control in the mouth and pharynx for individuals with dysphagia and may enter the airway more easily. Thickened liquids are usually preferred instead, as they are easier to manage and reduce aspiration risk.
C. Offer the client liquids with a syringe during meals: Offering liquids with a syringe can create a strong, uncontrollable flow into the mouth increasing the risk of aspiration, especially in clients who already have impaired swallowing reflexes. Syringes are generally not used for feeding unless under very specific clinical circumstances and professional supervision.
D. Instruct the client to tuck their chin to their chest before swallowing: Tucking the chin to the chest (chin-tuck maneuver) helps close off the airway by narrowing the entrance to the trachea and directing the food or liquid more safely toward the esophagus. It is a simple yet effective method to significantly reduce aspiration risk in individuals with swallowing difficulties.

Correct Answer is C

Explanation

A. Platelets 130,000/mm³ (150,000 to 400,000/mm³). This value is slightly below normal and indicates mild thrombocytopenia. While it should be monitored, it is not immediately life-threatening and does not typically require urgent intervention in the absence of active bleeding or symptoms.
B. Creatinine 1.3 mg/dL (0.5 to 1.1 mg/dL). This level is slightly elevated and may suggest early renal impairment, which is a concern in clients with diabetes. However, it does not require urgent reporting unless there are signs of acute kidney injury or rapid progression.
C. Glucose 423 mg/dL (74 to 106 mg/dL). This critically high blood glucose level indicates severe hyperglycemia and places the client at immediate risk for complications such as diabetic ketoacidosis (DKA). This finding requires prompt reporting and intervention to prevent further deterioration.
D. HbA1c 9% (4% to 5.99%). This value reflects poor long-term glycemic control and increases the risk of chronic complications, but it does not indicate an acute emergency. It requires follow-up, not immediate action.

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