For a client with Hodgkin disease who has developed neutropenia, what is an appropriate nursing intervention to include in the care plan?

Reasoning:

Choice A reason: Explaining that physical changes in Cushing’s syndrome, like moon face and weight gain, result from excessive corticosteroids helps the client understand their condition. Cortisol excess causes fat redistribution and metabolic changes, and education promotes adherence to treatment and coping with body image changes, improving psychological and physical management.

Choice B reason: Offering cool, comfortable clothing or bedding addresses symptoms like heat intolerance in Cushing’s syndrome due to cortisol’s metabolic effects. However, it is less critical than education about the condition, as it does not address the underlying cause or promote understanding and adherence to long-term management strategies.

Choice C reason: Increasing salt and fluid intake is appropriate for Addison’s disease, not Cushing’s syndrome, where cortisol’s mineralocorticoid effects cause fluid retention and hypertension. This intervention could worsen fluid overload and hyponatremia, making it inappropriate and potentially harmful for managing Cushing’s syndrome symptoms.

Choice D reason: A high-carbohydrate, low-protein diet is not recommended for Cushing’s syndrome. Cortisol excess causes protein catabolism and hyperglycemia, so a balanced diet with adequate protein supports muscle maintenance and glucose control. This dietary suggestion does not address the metabolic needs of the condition.

Choice A reason: Assessing color, warmth, movement, and sensation of extremities is relevant for neurological or vascular conditions, not a fluid deprivation test. This test induces dehydration to evaluate ADH function, which primarily affects fluid status and cardiovascular parameters, not peripheral limb function, making these assessments less critical for monitoring during the test.

Choice B reason: Breath and bowel sounds are not prioritized during a fluid deprivation test. The test assesses the body’s ability to concentrate urine under dehydration stress, primarily impacting fluid and cardiovascular status. Respiratory and gastrointestinal functions are not directly affected by short-term fluid restriction in diagnosing diabetes insipidus.

Choice C reason: Heart rate and blood pressure are critical during a fluid deprivation test, as dehydration from fluid restriction can cause hypovolemia, leading to tachycardia and hypotension. Monitoring these parameters ensures patient safety and detects cardiovascular responses to fluid loss, which are key to evaluating the severity of diabetes insipidus.

Choice D reason: Temperature and oxygen saturation are secondary in a fluid deprivation test. Dehydration may cause slight temperature changes, but these are not primary indicators. Oxygen saturation remains stable unless severe hypovolemia leads to shock, which is rare in a controlled setting, making these assessments less critical than cardiovascular monitoring.