A nurse is assessing a client who is receiving radiation therapy to the head and neck. Which of the following findings should the nurse expect?

Xerostomia

Epistaxis

Tinnitus

Diplopia

Answer and Explanation

The Correct Answer is A

A. Xerostomia: Radiation therapy to the head and neck often damages the salivary glands, leading to xerostomia, or dry mouth. This can cause difficulty in speaking, swallowing, and an increased risk of oral infections. Providing oral hydration and saliva substitutes can help manage this side effect.

B. Epistaxis: While radiation therapy can cause mucosal irritation, epistaxis (nosebleeds) is not a common side effect. Epistaxis is more frequently associated with conditions such as nasal trauma, clotting disorders, or chemotherapy-induced thrombocytopenia rather than localized radiation therapy.

C. Tinnitus: Radiation therapy does not typically cause tinnitus, which is more commonly linked to ototoxic medications, prolonged noise exposure, or inner ear disorders. If a tumor or treatment affects the auditory structures, hearing-related symptoms may occur but are not a primary radiation side effect.

D. Diplopia: Double vision is not a usual complication of radiation therapy to the head and neck. Diplopia is more commonly associated with neurological conditions, cranial nerve dysfunction, or ocular disorders rather than radiation-induced effects on surrounding tissues.

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

Explanation

A. Born with a high birth weight: Hearing loss is more commonly associated with low birth weight rather than high birth weight. Premature infants or those with complications like neonatal hypoxia are at a greater risk of auditory damage due to underdeveloped structures and increased vulnerability to infections.

B. Frequent exposure to low-volume noise: Prolonged exposure to loud noise, not low-volume noise, is a significant risk factor for hearing loss. High-decibel sounds can cause permanent damage to the cochlear hair cells, leading to sensorineural hearing loss, especially in occupational or recreational settings.

C. Use of a loop diuretic: Loop diuretics like furosemide can be ototoxic, especially when administered in high doses or given too rapidly through IV. They can cause reversible or permanent hearing loss by damaging the stria vascularis of the cochlea, which affects inner ear fluid balance.

D. Chronic infections of the middle ear: Recurrent otitis media can lead to chronic inflammation, scarring, or ossicle damage, resulting in conductive hearing loss. Long-term infections may also cause cholesteatoma formation, which can further impair hearing by destroying middle ear structures.

E. Perforation of the eardrum: Tympanic membrane rupture due to infections, trauma, or barotrauma can lead to conductive hearing loss by impairing sound transmission. While small perforations may heal spontaneously, larger tears might require surgical repair to restore normal hearing function.

A. WBC 12,000/mm3 (5,000 to 10,000/mm3) B. 25-Hydroxyvitamin D 92 ng/mL (25 to 80 ng/mL) C. Hgb 18 g/dL (12 to 16 g/dL) D. Albumin 3.1 g/dL (3.5 to 5 g/dL)

Correct Answer is D

Explanation

A. WBC 12,000/mm³ (5,000 to 10,000/mm³): An elevated white blood cell count suggests inflammation or infection, but it does not directly indicate an increased risk for skin breakdown. Skin integrity is more affected by nutritional status, mobility, and pressure exposure.

B. 25-Hydroxyvitamin D 92 ng/mL (25 to 80 ng/mL): This level is within the normal range and does not contribute to an increased risk for skin breakdown. Adequate vitamin D supports bone health and immune function, but protein levels and overall nutrition play a more direct role in skin integrity.

C. Hgb 18 g/dL (12 to 16 g/dL): A hemoglobin level above the normal range suggests polycythemia, which can increase blood viscosity. However, it does not directly correlate with skin breakdown risk. Lower hemoglobin levels, indicating anemia, are more likely to impair wound healing.

D. Albumin 3.1 g/dL (3.5 to 5 g/dL): A low albumin level reflects poor protein status, which is a key risk factor for skin breakdown. Protein is essential for tissue repair and maintaining skin integrity, and hypoalbuminemia is commonly associated with increased susceptibility to pressure injuries in immobile clients.

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A nurse is assessing a client who is receiving radiation therapy to the head and neck. Which of the following findings should the nurse expect?

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