The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?

Sodium level of 136 mEq/L, potassium level of 4.5 mEq/L.

Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L.

Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L.

Sodium level of 144 mEq/L, potassium level of 3.7 mEq/L.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

The sodium level is within the normal range, but the potassium level is slightly elevated. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

Choice B rationale:

The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

Choice C rationale:

Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L is the correct answer. In this option, both sodium and potassium levels are within normal ranges. Changing the IV prescription to DSNS with 20 mEq KCl/L ensures that the patient receives adequate hydration (from the dextrose and normal saline) without causing hyperkalemia.

Choice D rationale:

The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.

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Correct Answer is D

Explanation

Choice A rationale:

A lumbar puncture is not typically performed to rule out bone marrow involvement in non-Hodgkin lymphoma. Imaging studies and bone marrow biopsies are more appropriate for evaluating bone marrow involvement.

Choice B rationale:

Determining the level of cell differentiation is not the primary purpose of a lumbar puncture in non-Hodgkin lymphoma. This information is usually obtained from a biopsy of the affected lymph nodes or organs.

Choice C rationale:

Identifying the specific lymph cell type involved is not the main objective of a lumbar puncture in non-Hodgkin lymphoma. This information is usually determined through lymph node biopsy and other imaging studies.

Choice D rationale:

The purpose of a lumbar puncture in non-Hodgkin lymphoma is to find any central nervous system involvement. Lymphoma cells can spread to the central nervous system, and a lumbar puncture allows for the examination of cerebrospinal fluid to detect any cancerous cells, which can guide treatment decisions.

A. Restricting all visitors. B. Placing the patient in a private room. C. Advising the patient to use only an electric shaver. D. Wearing a gown and gloves when in direct contact with the patient.

Correct Answer is B

Explanation

Choice A rationale:

Restricting all visitors might be beneficial in preventing infections, but it is not the most important strategy for a patient with neutropenia. The main concern is the risk of infections due to the compromised immune system.

Choice B rationale:

Placing the patient in a private room is crucial for a neutropenic patient. Neutropenia, characterized by a low absolute neutrophil count (ANC), significantly compromises the patient's immune system, making them highly susceptible to infections. Isolating the patient helps minimize the risk of exposure to pathogens, reducing the likelihood of infections.

Choice C rationale:

Using an electric shaver instead of a razor is advisable to prevent cuts and minimize the risk of skin infections. While this is a good practice, it is not the most important strategy compared to isolating the patient and using personal protective equipment (PPE) during direct patient care.

Choice D rationale:

Wearing a gown and gloves when in direct contact with the patient is essential to prevent the spread of infections. This is a necessary measure, but isolating the patient in a private room takes precedence as it minimizes the risk of exposure to pathogens, providing a safer environment for the neutropenic patient.

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The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?

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Naxlex Comprehensive Predictor Exams

Which explanation will the nurse give a patient with non-Hodgkin lymphoma about the purpose of a planned lumbar puncture?

Correct Answer is D

Explanation

Which strategy is most important for a nurse to include when planning care for a patient who has neutropenia?

Correct Answer is B

Explanation

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