You are caring for a patient with an Absolute Neutrophil Count (ANC) of 400. The physician orders the patient to be placed on neutropenic precautions. Which of the following would be appropriate to implement? (Select all that apply)

Use a positive pressure room if available

Restrict any visitors until the patient's ANC counts return to normal

Use a negative pressure room if available

No live plants or fruits in the room

Ensure all entrants into room wash their hands

Answer and Explanation

Correct Answer : A,B,D,E

A.   A positive pressure room helps prevent outside air (and potential pathogens) from entering the room, providing a safer environment for neutropenic patients.
B.   Visitors can introduce infections, so it’s wise to restrict them, especially those who are ill or have been exposed to infectious diseases.
C.   Negative pressure rooms are used for patients with airborne infections (like tuberculosis) to prevent pathogens from escaping the room. Neutropenic patients require a protected environment, not one that allows outside air to flow in.
D.   Live plants and unwashed fruits can harbor bacteria and fungi that pose a risk to neutropenic patients, who have compromised immune systems.
E.   Hand hygiene is one of the most effective ways to prevent the spread of infections. Everyone entering the room should wash their hands to minimize the risk of introducing pathogens.

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Correct Answer is D

Explanation

A. While monitoring drug levels is important, sending a trough level before the initial dose is not standard practice. Trough levels are typically checked just before the next dose of a medication is given, especially for antibiotics like Gentamicin that require monitoring for potential toxicity. Therefore, this option is not the best immediate action.
B. While managing the environment and ensuring patient privacy is important, this option does not address any immediate medical needs related to starting the antibiotic infusion.
C. Educating the patient about potential side effects is essential for informed consent and patient safety. However, while important, this is not the most critical action to take prior to the infusion.
D. Before starting an antibiotic treatment, it is crucial to send a culture and sensitivity test to identify the specific pathogen causing the infection. This ensures that the selected antibiotic (Gentamicin) is appropriate for the identified bacteria, which is vital for effective treatment and to avoid antibiotic resistance.

A. Can cause sodium and fluid retention. B. Long-term effects include fat redistribution. C. Might make the client feel jittery or nervous. D. Never stop prednisone abruptly.

Correct Answer is D

Explanation

A. Prednisone can lead to sodium and fluid retention, which can result in hypertension and edema. While this is an important consideration, it is not the most critical point to emphasize initially. Managing weight and blood pressure is essential, but there are more immediate concerns with the medication's use.
B. Long-term use of prednisone can result in changes such as fat redistribution, leading to a "moon face," buffalo hump, and increased abdominal fat. This is significant for understanding the side effects of prolonged therapy, but it is not the most urgent information for the client to know.
C. Prednisone can cause side effects such as mood changes, anxiety, or jitteriness, especially when initiating treatment or adjusting dosages. While this is relevant, the potential for emotional or psychological effects is secondary to the critical management of the medication.
D. This is the most critical point to emphasize. Prednisone is a corticosteroid that can suppress the body's natural adrenal function. Abrupt discontinuation can lead to adrenal crisis, which can be life- threatening.

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You are caring for a patient with an Absolute Neutrophil Count (ANC) of 400. The physician orders the patient to be placed on neutropenic precautions. Which of the following would be appropriate to implement? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is teaching the client with systemic lupus erythematosus about prednisone. What information is the priority?

Correct Answer is D

Explanation

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