Which instruction is most important for the nurse to give a client who is receiving radiation therapy for lung cancer when teaching about skin care?

Ice packs may be applied to the site for 30 minutes every hour for comfort

Wear loose soft clothing over the treated area

Do not share bathrooms or toilets with others for 48 hours after treatment

Incorporate rest periods within the day

Answer and Explanation

The Correct Answer is B

A. Applying ice packs to the radiated area is not typically recommended, as it can cause additional skin irritation or damage. Skin care after radiation usually focuses on keeping the skin moisturized and protected.
B. Wear loose soft clothing over the treated area is the most important instruction because radiation therapy can cause skin irritation and sensitivity. Wearing loose, soft clothing helps to avoid further friction or irritation on the sensitive skin in the treated area.
C. Avoiding sharing bathrooms or toilets with others for 48 hours after treatment is not a required precaution for external radiation therapy, as there is no significant risk of radiation exposure to others through contact with shared bathroom facilities. This is more applicable to certain types of radioactive implants or internal radiation therapies.
D. While rest is important during cancer treatment, this instruction is more general and not as specific to skin care management during radiation therapy. The primary focus for skin care would be preventing irritation and damage to the skin in the radiated area.

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Correct Answer is B

Explanation

A. A widening pulse pressure (the difference between systolic and diastolic blood pressure) can be a sign of increasing intracranial pressure (ICP), but it typically occurs later in the progression of ICP. Early signs of increased ICP are often more subtle and include changes in behavior and consciousness.

B. One of the earliest signs of increased ICP is altered mental status or behavioral changes, such as increasing restlessness or agitation. As pressure builds inside the skull, it affects the brain's ability to function normally, leading to these early signs. Restlessness may indicate that the brain is becoming less able to maintain normal function due to the increasing pressure.

C. A decrease in pulse rate may occur later in the course of increased ICP, particularly with severe increases in pressure. However, early signs typically involve changes in consciousness and mental status rather than changes in vital signs like heart rate.

D. Dilated and fixed pupils are a late sign of increased ICP and usually indicate significant brain herniation or severe neurological compromise. While they are serious and require immediate attention, they do not typically occur at the early stages of increased ICP.

A. The client has a loss of appetite to owing surgery B. the client has absent bowel sounds in the lower abdominal quadrants C. The client is experiencing mild pain at the surgical site when sitting up. D. The client requires the use of a colostomy bag.

Correct Answer is B

Explanation

A. Loss of appetite following surgery is common due to the body’s stress response and recovery process. While this may affect nutrition, it is not immediately concerning unless it persists or is associated with other symptoms like vomiting or fever.
B. Absent bowel sounds in the lower abdominal quadrants is a serious concern and requires nursing intervention. It could indicate ileus or bowel obstruction, both of which can lead to serious complications such as bowel perforation or peritonitis. If bowel sounds are absent and the client is post-surgery, this may need further assessment and intervention.
C. Mild pain at the surgical site when sitting up is typical after surgery, especially abdominal surgery. Mild pain or discomfort is expected in the early post-operative period and generally does not require urgent intervention unless it becomes severe or is unmanageable.
D. The client requires the use of a colostomy bag – This is an expected and necessary part of recovery for clients undergoing surgery to redirect intestinal contents. It does not indicate a complication but rather a standard post-operative outcome.

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Which instruction is most important for the nurse to give a client who is receiving radiation therapy for lung cancer when teaching about skin care?

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