Which potential complication would the nurse identify as a high risk for a patient admitted to the hospital with pancytopenia? Select all that apply.

Bleeding.

Infection.

Seizures.

Neurogenic shock.

Pulmonary edema.

Answer and Explanation

Correct Answer : A,B

Choice A reason: Bleeding is a high-risk complication for patients with pancytopenia because of the low platelet count. Platelets are crucial for blood clotting, and their deficiency leads to an increased risk of spontaneous bleeding and difficulty in stopping bleeding once it starts. This can result in significant blood loss and complications if not managed promptly.
Choice B reason: Infection is another high-risk complication for patients with pancytopenia due to the low white blood cell count. White blood cells are essential for fighting infections, and their deficiency makes patients more susceptible to bacterial, viral, and fungal infections. These infections can be severe and difficult to control, leading to further complications and increased morbidity.
Choice C reason: Seizures are not typically associated with pancytopenia. Seizures are more commonly linked to neurological conditions, electrolyte imbalances, or other underlying medical issues rather than low blood cell counts.
Choice D reason: Neurogenic shock is not a common complication of pancytopenia. Neurogenic shock occurs due to a disruption in the autonomic nervous system, often resulting from spinal cord injuries or severe central nervous system damage, rather than low blood cell counts.
Choice E reason: Pulmonary edema is not directly related to pancytopenia. Pulmonary edema involves fluid accumulation in the lungs, often due to heart failure, kidney disease, or other causes, rather than low blood cell counts.

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Correct Answer is C

Explanation

Choice A reason: Increased serum chloride is not a typical finding associated with syndrome of inappropriate antidiuretic hormone (SIADH). In SIADH, the body's regulation of water is impaired, leading to water retention and dilutional hyponatremia. Serum chloride levels might not be significantly affected and are not the primary laboratory indicator for this condition.
Choice B reason: Elevated hematocrit is not directly related to SIADH. Hematocrit levels reflect the proportion of red blood cells in the blood. In SIADH, the main issue is water retention leading to dilutional hyponatremia, rather than changes in red blood cell concentration. Therefore, hematocrit levels are not a key laboratory finding in this disorder.
Choice C reason: Decreased serum sodium, or hyponatremia, is a hallmark finding in SIADH. The excessive release of antidiuretic hormone (ADH) leads to water retention, diluting the sodium in the blood and resulting in low serum sodium levels. This hyponatremia can cause symptoms such as disorientation, headache, and muscle cramps, as seen in the patient. Monitoring and correcting serum sodium levels is crucial in the management of SIADH.
Choice D reason: Low urine specific gravity is not expected in SIADH. In fact, patients with SIADH typically have a high urine specific gravity due to the excessive release of ADH, which causes the kidneys to reabsorb water and concentrate the urine. This concentrated urine reflects the body's attempt to reduce water excretion in response to elevated ADH levels. Therefore, low urine specific gravity would not be an initial laboratory finding in this condition.

A. Assess for unilateral swelling, redness, and tenderness of either leg. B. Ask about any skin color changes that occur in response to cold. C. Palpate for the presence of dorsalis pedis and posterior tibial pulses. D. Look for the presence of tortuous veins bilaterally on the legs.

Correct Answer is C

Explanation

Choice A reason: Assessing for unilateral swelling, redness, and tenderness is important when evaluating for conditions such as deep vein thrombosis (DVT). However, this patient's symptoms of leg cramps and pain that subsides with rest are more indicative of peripheral artery disease (PAD) rather than DVT. Therefore, while this assessment is valuable in certain contexts, it is not the most relevant for this patient's symptoms.
Choice B reason: Asking about skin color changes that occur in response to cold can help identify conditions such as Raynaud's phenomenon, which causes extremities to change color in response to cold or stress. However, this patient's symptoms of intermittent leg cramps and pain with walking are more suggestive of PAD, making this question less relevant in this situation.
Choice C reason: Palpating for the presence of dorsalis pedis and posterior tibial pulses is the most appropriate focused assessment. This patient's symptoms of leg cramps and pain that resolve with rest suggest intermittent claudication, which is a hallmark of PAD. By palpating these pulses, the nurse can assess the adequacy of blood flow to the lower extremities, which is crucial in diagnosing PAD.
Choice D reason: Looking for the presence of tortuous veins bilaterally on the legs is important for identifying varicose veins, which are characterized by enlarged, twisted veins. While varicose veins can cause leg discomfort, they are not typically associated with the type of pain that subsides with rest. This patient's symptoms are more indicative of PAD, making this assessment less relevant.

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Which potential complication would the nurse identify as a high risk for a patient admitted to the hospital with pancytopenia? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient who is disoriented and reports a headache and muscle cramps is hospitalized with syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result would the nurse expect?

Correct Answer is C

Explanation

A patient at the clinic says, "I always walk after dinner, but lately my leg cramps and hurts after just a few minutes. The pain goes away after I stop walking, though." Which focused assessment would the nurse make?

Correct Answer is C

Explanation

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