Which initial assessment findings would the nurse expect in a client diagnosed with acute lymphocytic leukemia ALL? (SELECT ALL THAT APPLY)

Ascites

Alopecia

Generalized edema

Petechiae

Epistaxis

Answer and Explanation

Correct Answer : D,E

A) Ascites
Ascites, the accumulation of fluid in the peritoneal cavity, is not a typical initial assessment finding in acute lymphocytic leukemia (ALL). While ascites can occur in some cancers or in cases of liver failure, it is not a hallmark or common finding in ALL. The focus in ALL would generally be on hematologic and immunologic symptoms rather than fluid accumulation in the abdomen.

B) Alopecia
Alopecia (hair loss) is more commonly associated with chemotherapy treatment for leukemia rather than the leukemia itself. While chemotherapy for ALL can lead to hair loss, it is not typically an initial symptom of the disease itself. Alopecia may appear later, as a side effect of cancer treatment.

C) Generalized edema
Generalized edema (swelling) is not a common or early sign of acute lymphocytic leukemia. While edema can occur in certain malignancies or complications (like in cases of renal failure or heart failure), it is not typically an initial presenting symptom of ALL. The key manifestations of ALL tend to relate to hematologic abnormalities, rather than fluid accumulation.

D) Petechiae
Petechiae (small, red or purple spots on the skin) are a common finding in ALL. They occur due to thrombocytopenia (low platelet count), which is a hallmark of leukemia. Thrombocytopenia impairs the blood’s ability to clot, leading to bleeding under the skin. Petechiae is often one of the first visible signs of blood dyscrasia in leukemia patients.

E) Epistaxis
Epistaxis (nosebleeds) is another common initial finding in ALL. Like petechiae, epistaxis occurs due to thrombocytopenia, which impairs normal clotting and leads to spontaneous bleeding. Nosebleeds are frequently observed in patients with low platelet counts, especially in leukemia.

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Correct Answer is ["90"]

Explanation

Given:

Ordered dose of Alteplase: 0.9 mg/kg

Client weight: 220 pounds

Step 1: Convert the client's weight from pounds to kilograms:

1 pound (lb) = 0.453592 kilograms (kg)

Client weight in kg = 220 lbs x 0.453592 kg/lb = 99.76824 kg

Step 2: Calculate the total dose of Alteplase:

Total dose (mg) = Ordered dose (mg/kg) xClient weight (kg)

Total dose (mg) = 0.9 mg/kg x 99.76824 kg

Total dose (mg) = 89.801416 mg

Step 3: Round to the nearest whole number:

Total dose (mg) ≈ 90 mg

A. Provide honest answers to the cliche's questions B. Avoid eve contact with the client during care C. A Provide limited explanations of procedures needed for' D. Avoid giving the client choices regarding their care

Correct Answer is A

Explanation

A) Provide honest answers to the client’s questions:
Providing honest answers to the client's questions is essential in promoting comfort, especially when they have a new diagnosis of bladder cancer. Patients often experience anxiety and uncertainty when facing a new diagnosis, so being open and transparent with information can help alleviate fears and build trust.

B) Avoid eye contact with the client during care:
Avoiding eye contact with the client can contribute to feelings of isolation and discomfort. Eye contact is an important form of non-verbal communication that can help establish a rapport and show empathy. Avoiding eye contact could make the client feel rejected or neglected, which would increase their anxiety and distress.

C) Provide limited explanations of procedures needed for care:
Providing limited explanations of procedures may leave the client feeling more confused or fearful about what is happening. While it's important to avoid overwhelming the patient with too much information, clear and concise explanations about procedures and treatments are essential to reduce anxiety and help the patient feel more in control of the situation.

D) Avoid giving the client choices regarding their care:
Avoiding giving the patient choices can make them feel powerless, which can increase feelings of anxiety and frustration. Offering choices when appropriate allows the patient to feel more in control of their care, which can reduce stress and enhance their sense of autonomy.

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Which initial assessment findings would the nurse expect in a client diagnosed with acute lymphocytic leukemia ALL? (SELECT ALL THAT APPLY)

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Naxlex Comprehensive Predictor Exams

A client with an acute stroke must receive Alteplase 0.9 mg/kg. The client weighs 220 pounds. How should the client receive? (Round to the nearest whole number, do not use trailing zeros)

Correct Answer is ["90"]

Explanation

A nurse is caring for a client who has a new diagnosis of bladder cancer Which of the following interventions should the nurse take to promote comfort?

Correct Answer is A

Explanation

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