A patient receiving chemotherapy for chronic myelocytic leukemia has irritates mucous membranes. Which of the following mouth care interventions would the nurse include in the plan of care?

Swab teeth and mucous membranes four times daily with lemon-glycerin swabs

Brush teeth twice a day with a firm toothbrush

Use sponge Toothettes to clean teeth between meals

Use waxed floss between meals and at bedtime

Answer and Explanation

The Correct Answer is C

A.   Lemon-glycerin swabs can dry out and irritate oral tissues, increasing the risk of oral mucositis and infection.
B.   Using a firm toothbrush may be too harsh for irritated mucous membranes and can increase the risk of injury and bleeding.
C.   Gentle oral care is essential to avoid further irritation of the mucous membranes.

D. Flossing may be too abrasive for irritated mucous membranes and can increase the risk of bleeding and injury.

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Correct Answer is B

Explanation

A. Sanguineous drainage is typically bright red and composed mainly of red blood cells. It is common immediately after surgery but does not typically indicate infection.
B. Purulent drainage is thick, yellow, or greenish in color and contains pus, indicating infection. It requires prompt assessment and intervention.
C. Serous drainage is clear, watery, and pale yellow in color. It is typically a normal finding in surgical wounds.
D. Serosanguineous drainage is pink to pale red and contains a mixture of blood and serum. It is common in the early stages of wound healing.

A. Examine the patient and collect data. B. Notify the health-care provider immediately. C. Obtain vital signs. D. Administer antiarrhythmic medication.

Correct Answer is B

Explanation

A. While assessment and data collection are important, the priority in the presence of a life-threatening arrhythmia is to initiate immediate interventions to address the situation.
B. The nurse should immediately inform the healthcare provider about the life- threatening arrhythmia to obtain further guidance and potential orders for intervention.
C. Vital signs are important, but they should not delay immediate action when a life- threatening arrhythmia is present.

D. Administering antiarrhythmic medication may be necessary, but the nurse should first notify the healthcare provider to obtain orders and guidance before administering any medications.

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A patient receiving chemotherapy for chronic myelocytic leukemia has irritates mucous membranes. Which of the following mouth care interventions would the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is 3 days postoperative following a cholecystectomy. The nurse suspects the client's wound is infected because the drainage from the dressing is yellow and thick. Which of the following findings should the nurse report as the type of drainage found?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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