The nurse is caring for a client who is receiving chemotherapy for acute lymphocytic leukemia (ALL). Which medical prescription should the nurse question?
Mechanical soft diet
Promethazine HCL 25 mg IM for nausea
No fresh fruits, flowers, or plants at the bedside
Ambulate with assistance
The Correct Answer is B
A. Mechanical soft diet: A mechanical soft diet is suitable for chemotherapy patients who may have difficulty swallowing or eating due to mouth sores. This prescription is appropriate and helps with nutrition during treatment.
B. Promethazine HCL 25 mg IM for nausea: In clients undergoing chemotherapy for ALL, especially with low platelet counts or risk of bleeding, intramuscula injections are avoided due to the potential for hematomas. Antiemetics can be given via oral, rectal, or IV routes instead, which are safer.
C. No fresh fruits, flowers, or plants at the bedside: This precaution is appropriate for chemotherapy patients who are immunocompromised, as fresh items may harbor bacteria or fungi. It helps reduce the risk of infection.
D. Ambulate with assistance: Encouraging ambulation with assistance is appropriate for preventing complications such as blood clots and improving circulation during chemotherapy. This order supports the patient’s mobility and safety.
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Related Questions
Correct Answer is C
Explanation
A. Physician order for life-sustaining treatment: Life-sustaining treatment is not part of the initial chemotherapy plan unless end-of-life decisions are involved. The focus is on managing side effects and preventing complications.
B. Encourage low residue foods: Low-residue foods are not a priority in the initial chemotherapy plan. The primary concern is managing immunosuppression and preventing infections, which makes neutropenic precautions more important.
C. Neutropenic precautions: Neutropenic precautions are crucial during induction chemotherapy to prevent infections due to the lowered white blood cell count. The nurse should educate the client on hygiene and infection prevention.
D. An advanced directive: While important, an advanced directive is not the immediate focus during chemotherapy. The initial plan centers on managing chemotherapy effects and preventing complications like infections.
Correct Answer is D
Explanation
A. If fatigue occurs, stop taking beta blockers: Fatigue can be a common side effect of beta blockers, but the nurse should not recommend stopping the medication without consulting the healthcare provider. Abruptly discontinuing beta blockers can worsen symptoms.
B. Limit fluid intake to 1000 mL per day: Limiting fluid intake to 1000 mL per day is not a standard for hypertrophic cardiomyopathy unless signs of fluid retention are present. Fluid restriction should be based on the client’s condition and any co-existing issues like heart failure.
C. Monitor weights daily: Monitoring daily weights is important for assessing fluid retention, but it is not the most crucial teaching point for hypertrophic cardiomyopathy. The primary concern is managing symptoms and avoiding strenuous activity.
D. Limit strenuous physical activity: Limiting strenuous physical activity is essential for clients with hypertrophic cardiomyopathy. Intense exercise can increase the risk of arrhythmias and sudden cardiac arrest. The client should avoid activities that strain the heart.
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