A patient with electrical burns develops arrhythmias. What is the nurse's priority action?

A. Teach about the importance of nutrition after treatment: While nutrition education is important for long-term recovery and maintaining strength, it does not prevent or control acute chemotherapy-induced nausea and vomiting during or immediately after treatment. This intervention alone is insufficient to manage the patient’s severe symptoms.

B. Offer dry crackers and carbonated fluids during the treatments: Small, bland snacks may provide some comfort, but offering them during chemotherapy is unlikely to prevent severe vomiting and diarrhea. The patient’s ability to tolerate oral intake is limited during active emesis, so this is supportive rather than preventive care.

C. Administer prescribed antiemetic 1 hour before the treatments: Prophylactic administration of antiemetics is the most effective strategy for controlling chemotherapy-induced nausea and vomiting. Giving the medication before treatment allows peak drug levels to coincide with chemotherapy exposure, reducing the severity and frequency of emesis and improving patient comfort.

D. Have the patient eat large meals when nausea is not present: Large meals can be difficult to tolerate and may exacerbate nausea or vomiting. Smaller, frequent meals are generally recommended for patients with chemotherapy-induced gastrointestinal upset, making this approach less effective than timely antiemetic therapy.

A. Platelet count: Chemotherapy and radiation commonly suppress megakaryocyte production in the bone marrow, leading to thrombocytopenia. A decreased platelet count increases the risk of spontaneous bleeding and impaired clot formation. Monitoring platelet levels allows early detection of marrow suppression and guides precautions or interventions.

B. Red blood cell (RBC) count: Myelosuppressive therapy can reduce erythropoiesis, resulting in anemia. A declining RBC count may lead to fatigue, dyspnea, and reduced oxygen-carrying capacity. Serial monitoring helps assess the severity of marrow suppression and determine the need for interventions such as erythropoiesis-stimulating agents or transfusion.

C. Basophil count: Basophils represent a very small fraction of circulating leukocytes and are not used as a primary indicator of bone marrow suppression. While they originate from the marrow, changes in basophil count are neither sensitive nor specific markers of chemotherapy-induced myelosuppression. Other white blood cell parameters provide more clinically meaningful data.

D. Neutrophil count: Neutropenia is a major and potentially life-threatening consequence of bone marrow suppression, significantly increasing the risk of infection. The absolute neutrophil count (ANC) is especially important in oncology patients to guide infection precautions and determine chemotherapy dosing adjustments. Monitoring neutrophils is critical for early identification of immunosuppression.