A nurse is assisting in the plan of care for a client who has immunosuppression following chemotherapy. Which of the following interventions should the nurse include in the plan of care?

Limit the number of health care workers entering the room.

Insert an indwelling catheter to monitor for sediment in the urine.

Take the client’s temperature once per shift

Provide the client with fresh fruit to avoid constipation

Answer and Explanation

The Correct Answer is A

A.   Limiting the number of health care workers entering the room helps reduce the risk of exposure to infections.
B.   Inserting an indwelling catheter is not a routine intervention for immunosuppressed clients and may increase the risk of infection.
C.   Monitoring temperature more frequently than once per shift is crucial to detect early signs of infection in immunosuppressed clients.
D.   Fresh fruit may carry a risk of bacterial contamination, and caution should be exercised in providing it to immunosuppressed clients.

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

Explanation

A. Low body mass index (BMI) can be associated with malnutrition, which may compromise the immune system and increase susceptibility to infection.
B. Diabetes can weaken the immune system and increase the risk of infections.
C. Smoking is a risk factor for various health issues, but it is not a direct factor that increases susceptibility to infection in this context. The client is a non-smoker.
D. Budesonide is a corticosteroid, and prolonged use of corticosteroids can suppress the immune system, making the individual more susceptible to infections.

Correct Answer is ["25"]

Explanation

To answer this question, you need to use the formula:

gtt/min = (Volume x Drop factor) / Time

Plug in the given values:

gtt/min = (100 mL x 15 gtt/mL) / 60 min

Simplify and solve:

gtt/min = 1500 gtt / 60 min gtt/min = 25 gtt/min

Therefore, the nurse should set the manual IV infusion to deliver 25 gtt/min.

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A nurse is assisting in the plan of care for a client who has immunosuppression following chemotherapy. Which of the following interventions should the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting in the care of a client. Medication Administration Record Laboratory Results Hct 47% (379% to 52%) Hgb 16 g/dL (12 to 18 g/dL) Potassium 3.6 mEq/L (3.5 to 5.0 mEq/L) Select the findings that increase the client’s susceptibility to infection. To unselect

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

Explanation

A nurse is preparing to administer dextrose 5% in water (DSW) 100 mL to infuse over 1 hr. The drop factor of the manual IV tubing is 15 gtt/ml. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number.)

Correct Answer is ["25"]

Explanation

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