The client has developed graft versus host disease (GVHD) during treatment for acute lymphoblastic leukemia (ALL). The client has a generalized pruritic rash on the trunk and the extremities. What nursing measures should the nurse use to address this problem?

Apply bacitracin liberally to the affected areas

Request a medical prescription for diphenhydramine or hydroxyzine

Instruct client to shower with cool water and use a mild soap

Clip fingernails and encourage the use of prescribed lotions

Answer and Explanation

Correct Answer : B,C,D

A.   Bacitracin is an antibiotic ointment typically used to prevent or treat bacterial infections in minor cuts and scrapes. It is not appropriate for treating a pruritic rash associated with GVHD. The rash may not be due to an infection but rather an immune response, so using bacitracin would not address the underlying issue.
B.   Diphenhydramine (Benadryl) and hydroxyzine are antihistamines that can help alleviate itching and provide relief from pruritus. Requesting a prescription for one of these medications is an appropriate response to manage the symptoms of GVHD.
C.   Showering with cool water can soothe irritated skin and reduce itching. Using mild soap helps to avoid further irritation or dryness that harsher soaps can cause. This intervention supports skin care and helps manage pruritus effectively.
D.   Clipping fingernails can help prevent skin damage from scratching, which could lead to secondary infections. Encouraging the use of prescribed lotions can help keep the skin moisturized and alleviate dryness, further addressing the pruritus associated with GVHD.

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Correct Answer is ["A","C","D","E"]

Explanation

A. Multiple myeloma can lead to dehydration and kidney problems. Increasing fluid intake helps to prevent these complications and can also help to reduce the risk of infections.
B. This statement is incorrect. Aspirin should not be taken unless prescribed by a doctor. It can increase the risk of bleeding in people with multiple myeloma.
C. Multiple myeloma can weaken the immune system, making the client more susceptible to infections. Using fragrance-free gel soap can help to reduce the risk of skin irritation and infections.
D. Multiple myeloma can cause bone pain. Using analgesics as needed can help to manage this pain and improve the client's quality of life.
E. Multiple myeloma can weaken bones, increasing the risk of fractures. Installing grab bars in the shower can help to prevent falls and reduce the risk of injuries.

A. cancer antigen 125 (CA-125) and serum ceruloplasmin. B. human chorionic gonadotropin (hCG) and alpha-fetoprotein (AFP). C. serum erythropoietin (EPO) and carcinoembryonic antigen (CEA). D. prostate specific antigen (PSA) and human chorionic gonadotropin (hCG).

Correct Answer is B

Explanation

A. CA-125 is primarily associated with ovarian cancer and is not a relevant tumor marker for testicular cancer. Serum ceruloplasmin is a copper-carrying protein that can be elevated in various conditions, but it is not specific for testicular cancer. Therefore, this option is not appropriate.
B. Both hCG and AFP are tumor markers specifically associated with testicular cancer. Elevated levels of these markers can indicate the presence of non-seminomatous testicular tumors. Monitoring these markers is essential for diagnosis, assessing treatment response, and detecting recurrence.
C. EPO is involved in red blood cell production and is not a tumor marker for testicular cancer. CEA is primarily associated with colorectal cancer and some other malignancies, but it is not specific for testicular cancer.
D. PSA is a tumor marker associated with prostate cancer, not testicular cancer. While hCG is relevant for testicular cancer, the inclusion of PSA makes this option inappropriate for a client with testicular cancer.

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ABG Value	Normal Range
PH	7.35-7.45
PaCO2	35-45 mm Hg
HCO3-	22-26 mEq/L
Base excess	-2 to +2
PaO2	80-95 mm Hg
SaO2	>95%

The client has developed graft versus host disease (GVHD) during treatment for acute lymphoblastic leukemia (ALL). The client has a generalized pruritic rash on the trunk and the extremities. What nursing measures should the nurse use to address this problem?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","C","D","E"]

Explanation

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Correct Answer is B

Explanation

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