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

Explanation

A. The elevated pH and decreased PaCO2 indicate that the respiratory system is causing alkalosis, typically due to hyperventilation (excessive breathing).
B. Metabolic alkalosis would be indicated by a high pH with a normal or high HCO3. Since the HCO3 level is normal and the PaCO2 is low, this does not fit the picture of metabolic alkalosis.
C. Respiratory acidosis would be characterized by a low pH and an elevated PaCO2 due to inadequate ventilation and accumulation of carbon dioxide. Here, the pH is high, and the PaCO2 is low.
D. Metabolic acidosis would be indicated by a low pH with a low HCO3. In this case, the pH is high, and the HCO3 is normal.

A. "I should use a heating pad for the pain." B. "Epididymitis usually resolves without any treatment." C. "My sexual partner needs to be treated with antibiotics." D. "After radiation treatment, I will make sure that I am meticulous about skin care."

Correct Answer is C

Explanation

A. While applying heat may help alleviate discomfort, it is not the primary recommendation for managing epididymitis. The treatment often involves rest, elevation of the scrotum, and possibly cold packs rather than heat. Therefore, while this statement may reflect some understanding, it is not the best indicator of comprehensive knowledge about managing epididymitis.
B. While some mild cases may improve spontaneously, most cases of epididymitis require treatment, especially if they are caused by infections, which are common. Untreated epididymitis can lead to complications, so this statement does not reflect an accurate understanding of the condition.
C. If epididymitis is caused by a sexually transmitted infection (STI), it is important that sexual partners be evaluated and treated as well to prevent reinfection. This indicates a proper understanding of the implications of the condition, particularly in the context of STIs.
D. It seems to reference concerns related to radiation therapy, which is unrelated to the management or understanding of epididymitis. This indicates a lack of focus on the current diagnosis and its implications.

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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

Correct Answer is A

Explanation

The nurse is caring for a 35-year-old male who is diagnosed with epididymitis. Which statement would indicate the client understands teaching about this condition?

Correct Answer is C

Explanation

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