The nurse is caring for a client diagnosed with acute myelogenous leukemia (AML) who is receiving outpatient chemotherapy. What should the nurse include in the teaching plan for this client?

Increase the use of humidifiers throughout the house

Encourage stress reducing home activities such as gardening.

Notify the primary care provider if the rectal temperature exceeds 100.2 F

Avoid fresh vegetables that are not cooked or peeled

Answer and Explanation

Correct Answer : C,D

A. Using humidifiers can help maintain moisture in the air, which is beneficial if the client is experiencing dry mucous membranes or respiratory discomfort, especially due to chemotherapy. However, while this can be helpful, it’s not the most critical teaching point compared to other options related to infection risk or symptoms monitoring.
B. While engaging in stress-reducing activities is important for overall well-being, gardening may pose specific risks for a client with AML, particularly concerning exposure to soil and potential pathogens. Activities should be carefully considered to avoid any risks of infection or physical strain.
C. Clients with AML, especially those undergoing chemotherapy, have a higher risk of infections due to neutropenia (low white blood cell count). A fever of 100.2°F or higher can be a sign of infection and requires prompt medical evaluation. Thus, this is a crucial point for the client to understand.
D. Fresh vegetables that are not cooked or peeled can harbor bacteria and other pathogens that could pose a risk of infection, especially in immunocompromised patients. Clients undergoing chemotherapy should avoid raw foods that can increase the risk of infections.

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Correct Answer is D

Explanation

A. This option is primarily aimed at promoting lung expansion and preventing atelectasis (collapse of the lung). While it's an important post-operative intervention, it does not directly reduce the risk of embolic events related to venous thromboembolism.
B. Reporting significant pain (8/10) may indicate complications such as infection or improper healing, but it does not directly relate to reducing the risk of embolic events. While managing pain is important for recovery, simply reporting it does not contribute to preventing VTEs.
C. Assessing popliteal pulses is part of a thorough circulatory assessment, but it mainly focuses on blood flow to the lower extremities rather than preventing embolic events. It can help identify existing DVT but does not actively reduce the risk of embolism.
D. This statement is true and is the best choice for decreasing the risk of an embolic event. Early ambulation promotes venous return, improves circulation, and significantly lowers the risk of DVT and pulmonary embolism in post-operative patients. Encouraging patients to get out of bed and move around as soon as they are stable is a key nursing intervention in post-operative care.

A. Obtain a prescription for stool occult blood testing B. Encourage intake of oral fluids to 3000 mL/day C. Assess the temperature every four hours D. Provide oral hygiene every two hours

Correct Answer is C

Explanation

A. This intervention can be appropriate since a very low platelet count increases the risk of bleeding, including gastrointestinal bleeding. However, this action alone does not directly address the immediate risks associated with the low platelet count.
B. While hydration is important for overall health, this intervention does not specifically address the risks associated with a low platelet count. Additionally, excessive fluid intake may not be appropriate for all patients, especially if there are underlying kidney issues or fluid restrictions.
C. Clients with AML and low platelet counts are at increased risk for infections and may develop febrile neutropenia. Monitoring temperature every four hours can help detect early signs of infection, allowing for timely intervention.
D. While maintaining oral hygiene is important, especially in patients undergoing chemotherapy, this intervention may not be the most critical action based on the acute concern of a very low platelet count. However, it is important to note that patients with low platelet counts may also experience bleeding from the gums, making gentle oral care essential.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male: 451-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-155 g/dL
Hematocrit	42%-52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 10/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%


Platelets	150,000-450,000/mm3

The nurse is caring for a client diagnosed with acute myelogenous leukemia (AML) who is receiving outpatient chemotherapy. What should the nurse include in the teaching plan for this client?

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Explanation

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Explanation

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