The nurse is preparing discharge teaching for a client newly diagnosed with cancer who just had a tunneled IV catheter (Hickman) placed. The nurse would include which information in the teaching plan regarding sign and symptoms of infection?

Notify the primary care provides with increased urine output

Assess daily for redness. swelling or exudate at insertion site weekly

The primary care provider will monitor hemoglobin and a hematocrit values

To maintain patency, the catheter should be flushed weekly using at 5ml syringe

Answer and Explanation

The Correct Answer is B

A) Notify the primary care provider with increased urine output
Increased urine output is not directly related to signs or symptoms of infection associated with a tunneled IV catheter, such as a Hickman catheter. While changes in urinary output might indicate renal or other systemic issues, they do not signal a local infection at the insertion site.

B) Assess daily for redness, swelling, or exudate at insertion site weekly
One of the most common complications of a tunneled IV catheter, such as a Hickman, is infection at the insertion site or along the catheter tract. The nurse should instruct the patient to monitor for signs of infection, including redness, swelling, and exudate (pus or drainage) at the insertion site. These signs suggest possible infection, and early detection is critical to preventing more serious complications like sepsis.

C) The primary care provider will monitor hemoglobin and hematocrit values
While monitoring hemoglobin and hematocrit values is important for assessing overall health and blood status, it is not specifically related to monitoring for infection in a client with a tunneled IV catheter. Hemoglobin and hematocrit can provide information about anemia or dehydration but do not directly indicate an infection at the insertion site.

D) To maintain patency, the catheter should be flushed weekly using a 5ml syringe
Although flushing a tunneled IV catheter to maintain patency is important, this response does not directly address infection prevention, which is the focus of the question. Typically, a catheter should be flushed as per specific guidelines (which may include daily or weekly flushing, depending on the clinical setting).

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Correct Answer is C

Explanation

A) A Rhinovirus infection can cause cancer of the cervix
Rhinovirus is primarily associated with the common cold and respiratory infections, not with cervical cancer. The risk factors for cervical cancer are related to persistent infections with certain strains of the human papillomavirus (HPV), especially high-risk types like HPV-16 and HPV-18, which can lead to cervical dysplasia and, eventually, cervical cancer.

B) Eating foods high in fat and taking birth control pills are risk factors
While diet and certain medications may influence overall health, eating foods high in fat and taking birth control pills are not primary risk factors for cervical cancer. Research has shown that certain hormonal contraceptives (especially long-term use) may slightly increase the risk of cervical cancer, but the most significant and well-established risk factor is HPV infection, not fat intake or birth control use.

C) The earlier the age of sexual activity and the more partners, the greater the risk
The major risk factor for cervical cancer is persistent infection with high-risk HPV. Early initiation of sexual activity and having multiple sexual partners increase the risk of HPV infection, which is a leading cause of cervical cancer. HPV is transmitted through sexual contact, and early exposure to the virus, as well as repeated exposure to multiple partners, increases the likelihood of acquiring a high-risk strain of HPV.

D) Having yearly Pap smears will protect you from developing cancer
While Pap smears (Pap tests) are important for detecting precancerous changes (such as dysplasia) or early-stage cervical cancer, they do not prevent cancer. Pap smears can help identify abnormal cell changes that can be treated before they develop into cancer, but they do not protect against the development of cancer.

A. Intestines B. Liver C. Spleen D. Stomach

Correct Answer is C

Explanation

A) Intestines:
While abdominal trauma can affect the intestines, Kehr's sign, Cullen's sign, and Gray Turner's sign are more commonly associated with damage to the spleen rather than the intestines. Kehr's sign, in particular, is a hallmark of splenic injury, with pain referred to the left shoulder due to diaphragmatic irritation from blood in the peritoneum.

B) Liver:
Liver injuries often present with right upper quadrant pain, jaundice, and elevated liver enzymes. While liver injuries can cause internal bleeding, Cullen's and Gray Turner's signs are more closely associated with retroperitoneal bleeding from the spleen rather than liver injuries. Kehr's sign, which is left-sided shoulder pain, would not typically indicate a liver injury.

C) Spleen:
The spleen is the most likely abdominal organ affected in this case due to the left-sided rib fractures. When the spleen is injured (often as a result of blunt trauma), it can cause intraperitoneal hemorrhage. This bleeding can irritate the diaphragm, leading to Kehr's sign, which presents as left shoulder pain. Additionally, Cullen's sign (periumbilical bruising) and Gray Turner's sign (flank bruising) are indicative of retroperitoneal bleeding, which can occur with splenic rupture or laceration.

D) Stomach:
While stomach injuries can occur with blunt abdominal trauma, they are less likely to cause the signs and symptoms seen in this patient (Kehr's, Cullen's, and Gray Turner's signs). Stomach trauma typically leads to pain and potential perforation, but it doesn't often cause the peritoneal bleeding patterns seen with splenic injuries.

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The nurse is preparing discharge teaching for a client newly diagnosed with cancer who just had a tunneled IV catheter (Hickman) placed. The nurse would include which information in the teaching plan regarding sign and symptoms of infection?

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