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Mrs. Miller is a 34 year-old who just successfully completed chemotherapy for breast cancer. Which of the following should the RN include in her plan of care?

Avoid elevated altitudes of greater than 2,000 feet (if possible) and air travel for 2-4 weeks (depending on the oncologist’s advice).

Avoid foods high in purine for 30-90 days (depending on the oncologist’s advice).

Avoid sun exposure for 60-90 days following chemotherapy (depending on oncologist’s advice).

Have a solid plan for contraception for 3 months to 2 years (depending on the oncologist’s advice).

Answer and Explanation

The Correct Answer is C

A. Avoid elevated altitudes of greater than 2,000 feet (if possible) and air travel for 2-4 weeks (depending on the oncologist’s advice):

Altitude and air travel restrictions are not common recommendations after completing chemotherapy.

B. Avoid foods high in purine for 30-90 days (depending on the oncologist’s advice):

Restrictions on foods high in purine are not typically associated with post-chemotherapy care.

C. Avoid sun exposure for 60-90 days following chemotherapy (depending on oncologist’s advice):

Chemotherapy can make the skin more sensitive to sunlight. Advising the patient to avoid sun exposure or take precautions such as using sunscreen can help prevent skin damage during this period.

D. Have a solid plan for contraception for 3 months to 2 years (depending on the oncologist’s advice):

Contraception considerations may be important, but the timeframe mentioned is not a standard recommendation following chemotherapy completion. The need for contraception may vary depending on the patient's overall health, reproductive goals, and specific chemotherapy drugs received. This decision is usually discussed with the healthcare provider on an individual basis.

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Correct Answer is C

Explanation

A. Tiotropium bromide (Spiriva)

Tiotropium bromide is a long-acting anticholinergic bronchodilator used for maintenance therapy in conditions like chronic obstructive pulmonary disease (COPD). It is not indicated for the immediate relief of acute asthma symptoms.

B. Montelukast (Singulair)

Montelukast is a leukotriene receptor antagonist used for maintenance therapy in asthma. It is not a rescue medication and does not provide immediate relief during an acute asthma attack.

C. Albuterol (Proventil)

In the case of an acute asthma attack, the nurse should prepare to administer a short-acting bronchodilator. Albuterol (Proventil) is a short-acting beta-agonist bronchodilator that provides rapid relief of bronchoconstriction and acute symptoms during an asthma attack.

D. Acetylcysteine (Mucomyst)

Acetylcysteine is a mucolytic agent used to help loosen and thin mucus in the airways. It is not indicated for the immediate relief of bronchoconstriction during an acute asthma attack.

A. Cardiac Enzymes B. Complete Blood Count with differential C. Chemistry Profile D. Liver Function Tests

Correct Answer is B

Explanation

A. Cardiac Enzymes

Cardiac enzymes are markers used to assess heart health and are not directly related to myelosuppression caused by chemotherapy. Monitoring cardiac enzymes is important for assessing heart function but is not the primary concern in the context of myelosuppression.

B. Complete Blood Count with differential

This is the correct choice. The complete blood count (CBC) with differential provides information about the levels of red blood cells, white blood cells, and platelets. Since myelosuppression affects blood cell production, monitoring the CBC with differential is crucial to detect and manage any abnormalities in these cell counts.

C. Chemistry Profile

A chemistry profile typically includes measurements of electrolytes, kidney function, and other metabolic parameters. While monitoring overall health is important, the specific concern with myelosuppression and chemotherapy is related to blood cell counts. Therefore, a complete blood count (CBC) is more directly relevant in this context than a chemistry profile.

D. Liver Function Tests

Liver function tests assess the health of the liver and are not directly related to myelosuppression caused by chemotherapy. These tests are important in certain situations, but they do not provide information about blood cell counts, which are the primary concern when dealing with myelosuppression.

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Mrs. Miller is a 34 year-old who just successfully completed chemotherapy for breast cancer. Which of the following should the RN include in her plan of care?

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