Which nursing intervention(s) should be employed when caring for the bone marrow donor immediately following a bone marrow aspiration? (SELECT ALL THAT APPLY)

Administer aspirin for bone pain

Place the client in high Fowler's position

Apply direct pressure to the puncture site

Assess and document vital signs

Initiate neutropenic precautions

Answer and Explanation

Correct Answer : C,D

A.   Aspirin can increase the risk of bleeding and is typically contraindicated in patients who have undergone procedures like bone marrow aspiration. Instead, acetaminophen may be recommended for pain relief, as it does not have blood-thinning effects.
B.   After a bone marrow aspiration, the donor is typically advised to lie flat or in a comfortable position to minimize discomfort and reduce the risk of bleeding. High Fowler's position may not provide the necessary comfort or support needed post-procedure.
C.   Applying direct pressure to the puncture site is a critical intervention to minimize bleeding and promote clotting at the site of the aspiration. The nurse should apply pressure for a sufficient amount of time as per protocol.
D.   Monitoring vital signs is important after any invasive procedure to detect any complications early, such as bleeding or signs of shock. Documenting vital signs also ensures continuity of care.
E.   This choice is not applicable immediately after bone marrow aspiration for a donor. Neutropenic precautions are typically implemented for patients who have low white blood cell counts due to chemotherapy or other conditions. Bone marrow donors do not require these precautions immediately after donation unless there is a specific concern for infection or a significant drop in white blood cell counts.

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Correct Answer is A

Explanation

A. Petechiae (small red or purple spots caused by bleeding under the skin) and epistaxis (nosebleeds) result from thrombocytopenia, which is a low platelet count often seen in leukemia. The compromised bone marrow function leads to inadequate production of platelets, resulting in bleeding and bruising.
B. While generalized edema and rash can occur in various conditions, they are not specific to ALL and are not common initial findings. Edema might be seen in certain contexts (e.g., renal involvement or fluid overload), but it is not a hallmark of ALL.
C. Alopecia (hair loss) and pallor (paleness) can occur in clients undergoing chemotherapy for ALL, but they are not typically initial findings at the time of diagnosis. Pallor may result from anemia, which can develop as a consequence of the disease, but it is not the most immediate or characteristic symptom of ALL.
D. Bradycardia (slow heart rate) and lethargy are not typical initial findings of ALL. Lethargy could be present due to anemia or other systemic effects, but bradycardia is not commonly associated with the disease and would require further investigation for other underlying causes.

Correct Answer is ["7"]

Explanation

(desired dose * volume of solution) / (concentration of drug * time) = rate.

For an infusion of 7 units per hour with a concentration of 100 units in 100 mL, the calculation would be: (7 units/hour * 100 mL) / (100 units * 1 hour) = 7 mL/hour.

Therefore, the nurse should set the IV pump to 7 mL per hour to deliver a continuous infusion of insulin at the prescribed rate.

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Which nursing intervention(s) should be employed when caring for the bone marrow donor immediately following a bone marrow aspiration? (SELECT ALL THAT APPLY)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which initial assessment finding(s) would the nurse expect in a client diagnosed with acute lymphocytic leukemia (ALL)?

Correct Answer is A

Explanation

A client is prescribed a continuous infusion of IV Insulin at 7 units per hour. Pharmacy delivers a concentration of 100 units of regular insulin in 100 mL of NSS. At what rate should the nurse set the IV pump? (round to the nearest whole number)

Correct Answer is ["7"]

Explanation

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