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. The elevated pH and decreased PaCO2 indicate that the respiratory system is causing alkalosis, typically due to hyperventilation (excessive breathing).
B. Metabolic alkalosis would be indicated by a high pH with a normal or high HCO3. Since the HCO3 level is normal and the PaCO2 is low, this does not fit the picture of metabolic alkalosis.
C. Respiratory acidosis would be characterized by a low pH and an elevated PaCO2 due to inadequate ventilation and accumulation of carbon dioxide. Here, the pH is high, and the PaCO2 is low.
D. Metabolic acidosis would be indicated by a low pH with a low HCO3. In this case, the pH is high, and the HCO3 is normal.

A. notify the provider if the urine output is absent." B. resume voiding normally within one week." C. take a stool softener daily to decrease the chance of straining." D. monitor the skin around the surgical site for redness."

Correct Answer is B

Explanation

A. After a radical cystectomy, the client may have a urinary diversion (such as a stoma) and should be vigilant about monitoring urine output. Absence of urine output can indicate a serious issue, and notifying the provider is crucial.
B. This statement indicates a need for further clarification. After a radical cystectomy, clients typically do not resume normal voiding because the bladder is removed. Instead, they may have a urinary diversion or need to learn how to manage their new urinary output. Normal voiding as before surgery is not possible, so this statement reflects a misunderstanding of the procedure's implications.
C. After surgery, particularly abdominal surgery like a radical cystectomy, patients are often advised to take stool softeners to prevent constipation. Straining can increase the risk of complications and affect the surgical site, so this is a valid precaution.
D. Monitoring the surgical site for signs of infection, such as redness, swelling, or discharge, is an essential part of post-operative care. Clients should be educated on how to check their surgical site for any concerning changes.

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ABG Value	Normal Range
PH	7.35-7.45
PaCO2	35-45 mm Hg
HCO3-	22-26 mEq/L
Base excess	-2 to +2
PaO2	80-95 mm Hg
SaO2	>95%

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

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Which statement, made by a client being discharged to home after a radical cystectomy, indicates a need for further clarification by the nurse? "I will:

Correct Answer is B

Explanation

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