A patient at the clinic says, "I always walk after dinner, but lately my leg cramps and hurts after just a few minutes. The pain goes away after I stop walking, though." Which focused assessment would the nurse make?

Choice A reason: Bleeding is a high-risk complication for patients with pancytopenia because of the low platelet count. Platelets are crucial for blood clotting, and their deficiency leads to an increased risk of spontaneous bleeding and difficulty in stopping bleeding once it starts. This can result in significant blood loss and complications if not managed promptly.
Choice B reason: Infection is another high-risk complication for patients with pancytopenia due to the low white blood cell count. White blood cells are essential for fighting infections, and their deficiency makes patients more susceptible to bacterial, viral, and fungal infections. These infections can be severe and difficult to control, leading to further complications and increased morbidity.
Choice C reason: Seizures are not typically associated with pancytopenia. Seizures are more commonly linked to neurological conditions, electrolyte imbalances, or other underlying medical issues rather than low blood cell counts.
Choice D reason: Neurogenic shock is not a common complication of pancytopenia. Neurogenic shock occurs due to a disruption in the autonomic nervous system, often resulting from spinal cord injuries or severe central nervous system damage, rather than low blood cell counts.
Choice E reason: Pulmonary edema is not directly related to pancytopenia. Pulmonary edema involves fluid accumulation in the lungs, often due to heart failure, kidney disease, or other causes, rather than low blood cell counts.

Choice A reason: Reassessing vital signs in 1 hour is not an immediate action and does not address the patient’s current symptoms of dizziness and unsteady gait, which indicate a potential problem that requires immediate attention. Waiting an hour to reassess may delay necessary interventions that could prevent harm.
Choice B reason: Assisting the patient into a sitting position and notifying the healthcare provider is the most appropriate action. The symptoms of dizziness and unsteady gait, along with a BP of 98/60 mmHg, suggest that the patient may be experiencing orthostatic hypotension or a side effect of Carbidopa-Levodopa. Elevating the patient's position can help prevent falls, and notifying the healthcare provider ensures that the situation is assessed and managed promptly. This action addresses the immediate safety of the patient and facilitates appropriate medical intervention.
Choice C reason: Administering the next dose of Carbidopa-Levodopa early is not recommended without specific orders from the healthcare provider. It could potentially lead to overmedication and worsen the patient’s symptoms or cause adverse effects. Medication administration should always follow the prescribed schedule unless otherwise directed by the healthcare provider.
Choice D reason: Educating the patient about increasing his exercise is important for overall health and mobility but is not an immediate intervention for the acute symptoms of dizziness and unsteady gait. The patient’s current condition requires prompt assessment and intervention rather than education on exercise, which can be addressed later once the immediate issue is managed.