Your patient has suspected aplastic anemia and has just returned to the unit to be cared for by you after having bone marrow biopsy done to confirm the diagnosis. Which of the following is the MOST appropriate nursing action?

Assess the patient's lower back for bleeding

Apply a heat pack to the biopsy site for comfort

Have the patient remain bedbound and NPO for 4-6 hours

Give aspirin for hip pain

Answer and Explanation

The Correct Answer is A

A.   This is a crucial action following a bone marrow biopsy, as there is a risk of bleeding at the biopsy site. Monitoring for signs of bleeding or hematoma formation is essential to prevent complications, making this a highly appropriate nursing action.
B.   While applying heat may provide comfort, it is generally not recommended immediately after a biopsy because it can increase blood flow to the area and potentially exacerbate bleeding. Thus, this action may not be appropriate right after the procedure.
C.   While some level of rest is important after a procedure, keeping the patient NPO (nothing by mouth) is unnecessary unless there are specific orders due to anesthesia or other considerations. Additionally, remaining bedbound could increase discomfort or risk of complications like deep vein thrombosis (DVT) if not warranted.
D.   Aspirin should be avoided in this scenario because it is an anticoagulant and can increase the risk of bleeding, particularly after a procedure like a bone marrow biopsy. Instead, other pain management strategies that do not affect clotting should be considered.

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Correct Answer is B

Explanation

A. Diabetes Insipidus is primarily related to issues with the production of vasopressin (ADH) or the body's response to it, which is not directly caused by CKD. CKD may lead to fluid retention and imbalances, but it does not typically cause recurrent bouts of diabetes insipidus.
B. In CKD, the kidneys lose their ability to produce erythropoietin, a hormone that stimulates red blood cell production in the bone marrow. Patients often require erythropoiesis-stimulating agents (ESAs) like erythropoietin injections to manage anemia associated with CKD.
C. CKD patients are often hyperkalemic (high potassium levels) rather than hypokalemic. As kidney function declines, the kidneys struggle to excrete potassium, leading to elevated levels, which can cause serious complications.
D. CKD patients often experience hypocalcemia (low calcium levels) due to several factors, including decreased activation of vitamin D and imbalances in phosphate levels. While some patients may experience transient hypercalcemia due to treatments or dietary factors, chronic hypercalcemia is not typical in CKD.

A. Trauma B. Hyperglycemia C. Infection D. Inflammation E. Steroid Injection

Correct Answer is ["A","C","D"]

Explanation

A. Trauma can cause an elevated WBC count as part of the body’s response to injury. The immune system reacts to tissue damage by increasing WBC production to facilitate healing and fight potential infections.
B. Hyperglycemia itself does not directly cause an elevated WBC count. However, it may be associated with conditions like diabetes, where infections are more common. Therefore, while hyperglycemia can occur concurrently with elevated WBC counts, it is not a direct cause of the increase.
C. Infection is one of the most common causes of an elevated WBC count. The body responds to infections (bacterial, viral, etc.) by increasing WBC production to help combat the invading pathogens.
D. Inflammation, whether due to autoimmune conditions, allergies, or other causes, can also lead to an increase in WBC count. The inflammatory process triggers the immune response, resulting in elevated levels of white blood cells.
E. While steroid injections can influence WBC counts, they often cause a redistribution of white blood cells rather than an increase in production. Corticosteroids can cause a decrease in certain types of white blood cells (like lymphocytes) but may increase neutrophils due to a release from the bone marrow.

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Your patient has suspected aplastic anemia and has just returned to the unit to be cared for by you after having bone marrow biopsy done to confirm the diagnosis. Which of the following is the MOST appropriate nursing action?

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