When teaching a patient about multiple myeloma, which intervention should the nurse stress to the client?

Drink at least 3000 ml of fluid per day

Keep lower extremities elevated

Notify physician for weight gain of 3-5 lbs (1.5-2.2 kg) in a week

Perform weight bearing exercises three times per day

Answer and Explanation

The Correct Answer is A

A. Drink at least 3000 ml of fluid per day: Multiple myeloma can lead to kidney damage, and increased fluid intake helps to prevent dehydration and kidney complications, such as renal failure. Staying well-hydrated is essential to help flush out excess calcium from the bloodstream and support kidney function.

B. Keep lower extremities elevated: Elevating lower extremities may be helpful for conditions involving fluid retention or edema, it is not specifically relevant for multiple myeloma. The priority is managing fluid balance and preventing kidney complications.

C. Notify physician for weight gain of 3-5 lbs (1.5-2.2 kg) in a week: While significant weight gain could indicate fluid retention or complications, it is more important for patients with multiple myeloma to monitor for signs of kidney issues or hypercalcemia.

D. Perform weight bearing exercises three times per day: Weight-bearing exercises can help with bone health, but due to the risk of bone fractures and weakened bones in multiple myeloma, patients are typically advised to avoid high-impact or strenuous activities.

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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.

A. Administering IV Lactated Ringers @ 150ml/hour B. Morphine 5 mg IV every 3 hours prn for pain C. Strict intake and output D. Insert an indwelling (Foley) catheter

Correct Answer is A

Explanation

A. Administering IV Lactated Ringers @ 150ml/hour: In major burns, the fluid resuscitation rate is initially aggressive to compensate for the large fluid loss. The Parkland formula is used to determine the volume for resuscitation, which would be much more than 150 mL/hour in the first 24 hours.

B. Morphine 5 mg IV every 3 hours prn for pain: Morphine is commonly used for pain management in burn patients, as burns are extremely painful. Administering morphine every 3 hours as needed is an appropriate prescription for managing moderate pain in burn patients.

C. Strict intake and output: Monitoring strict intake and output is a critical part of managing fluid balance in burn patients. It helps ensure that the patient is receiving and excreting the correct volume of fluids, which is crucial for avoiding fluid overload or dehydration.

D. Insert an indwelling (Foley) catheter: In major burns, inserting a Foley catheter is standard practice. It allows for accurate monitoring of urinary output, which is an essential part of fluid management and kidney function monitoring.

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When teaching a patient about multiple myeloma, which intervention should the nurse stress to the client?

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