The nurse is planning care for a patient who is on a protocol of Bleomycin.
Since Bleomycin is an anti-tumor antibiotic, which intervention should the nurse add to the care plan?

Choice A rationale

A persistent cough or hoarseness can indicate irritation or inflammation of the respiratory tract and vocal cords. In the context of cancer, particularly lung or laryngeal cancer, these symptoms may signify abnormal cell growth affecting these areas, leading to chronic irritation. Early detection relies on recognizing such persistent changes.

Choice B rationale

Gallbladder disease, such as cholecystitis or gallstones, primarily involves inflammation or calculi within the gallbladder. While it causes gastrointestinal symptoms like pain and indigestion, it is not recognized as one of the seven universally accepted warning signs for cancer. Its pathology is distinct from oncological processes.

Choice C rationale

Hematopoietic changes refer to alterations in blood cell production, potentially indicating conditions like leukemia or lymphoma. While these are significant signs of hematologic malignancies, the general "seven warning signals" typically focus on more outwardly manifest or commonly observed symptoms rather than specific hematologic lab abnormalities.

Choice D rationale

A non-healing sore suggests impaired tissue repair and uncontrolled cell proliferation, which are hallmarks of malignancy. Normal wound healing involves a coordinated cellular response, including inflammation, proliferation, and remodeling. A chronic, unhealing sore can indicate the presence of abnormal cells disrupting this process.

Choice A rationale

This response acknowledges the client's concern directly and validates their feelings about potential discomfort. It also provides reassurance by stating that measures will be taken to minimize pain, establishing trust and indicating a commitment to patient comfort. This therapeutic communication promotes a sense of control and prepares the client realistically for the procedure, promoting coping mechanisms.

Choice B rationale

This response is dismissive of the client's immediate concerns and shifts responsibility back to the provider, undermining the nurse's role in patient education and support. It does not address the client's anxiety about the procedure itself and can make the client feel unheard and unimportant. The nurse should be capable of addressing common procedure-related questions.

Choice C rationale

Bone marrow biopsies are typically performed under local anesthesia, not general anesthesia, meaning the client will be awake during the procedure, although discomfort will be managed. Providing inaccurate information can lead to a breach of trust and increased anxiety if the client realizes the information was incorrect during the procedure.

Choice D rationale

While the client might be worried about the biopsy results, the direct question was about the pain of the procedure. This response deflects from the immediate concern about physical discomfort and instead interprets the client's underlying emotional state, which is not what was asked. The nurse should directly answer the client's explicit question first.