The nurse is teaching a patient about taking immunosuppressant medications after an allogeneic stem cell transplant to treat leukemia.
What will the nurse teach is the indication for this treatment?
Prevent graft versus host disease.
Prevent graft rejection.
Prevent hospital acquired infections.
Prevent a relapse of the leukemia.
The Correct Answer is A
Choice A rationale
Prevent graft versus host disease (GVHD) is a common complication following an allogeneic stem cell transplant. Immunosuppressant medications are given to prevent the donor immune cells from attacking the recipient's body tissues, which is GVHD. This prevention is crucial for the success of the transplant and the patient's overall recovery.
Choice B rationale
Prevent graft rejection is more commonly associated with solid organ transplants like kidney or liver transplants. In the context of stem cell transplants, preventing GVHD is the primary concern rather than preventing graft rejection.
Choice C rationale
Preventing hospital-acquired infections is important for all patients, especially those with compromised immune systems. However, this is not the primary indication for immunosuppressant medications following an allogeneic stem cell transplant. Other measures, such as infection control protocols, are more directly related to this.
Choice D rationale
Preventing a relapse of leukemia is a key goal of the overall treatment plan for leukemia patients. However, immunosuppressant medications do not directly prevent a relapse; instead, they help manage complications like GVHD that can arise from the transplant process.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Regular insulin 10 units subcutaneous is used to lower blood glucose levels in hyperkalemia. While insulin can help shift potassium into cells, it is not indicated for hypercalcemia or hyperparathyroidism. Regular insulin would not address the elevated calcium levels in this patient.
Choice B rationale
Chlorothiazide 750 mg intravenous is a diuretic that can increase calcium reabsorption in the kidneys, potentially worsening hypercalcemia. It is contraindicated in hyperparathyroidism because it can exacerbate the high calcium levels and associated symptoms.
Choice C rationale
Calcitonin 300 international units subcutaneous is the correct choice for this patient. Calcitonin inhibits osteoclast activity, reducing bone resorption and lowering serum calcium levels. It provides rapid but short-term control of hypercalcemia, which is crucial for managing acute symptoms of hyperparathyroidism.
Choice D rationale
Calcitriol 0.75 mcg orally is an active form of vitamin D that increases calcium absorption in the gut. It is used to manage hypocalcemia, not hypercalcemia. Administering calcitriol would further elevate the already high calcium levels, worsening the patient's condition.
Correct Answer is C
Explanation
Choice A rationale
Neutropenic precautions and broad-spectrum antibiotics are indicated for patients with neutropenia to prevent infections. However, the patient's ANC is within the normal range (2400/mm³), so these measures are not necessary. This choice does not address the low hemoglobin and platelet count.
Choice B rationale
Contact isolation precautions and intravenous prednisone are not relevant to the patient's current condition. Prednisone is an immunosuppressive corticosteroid used for inflammatory and autoimmune conditions, but it does not address the patient's anemia or thrombocytopenia.
Choice C rationale
Bleeding precautions and platelet transfusion are appropriate interventions for the patient. The platelet count is critically low (6,000/mm³), putting the patient at high risk for spontaneous bleeding. Platelet transfusion is needed to increase platelet levels and reduce bleeding risk. Bleeding precautions, such as avoiding invasive procedures and using gentle oral care, help minimize the risk of hemorrhage.
Choice D rationale
Bedrest and packed red blood cell transfusion address the patient's anemia (hemoglobin 8.4 g/dL, hematocrit 25.9%). While these interventions are necessary to improve oxygen-carrying capacity, they do not address the critical issue of thrombocytopenia. Combining interventions C and D would be ideal for comprehensive care, but based on the question, Choice C is most critical for immediate bleeding risk management. .
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