A nurse is assisting with the plan of care for a client who has leukemia and whose platelet count is 50,000 mm. Which of the following interventions should the nurse include in the plan of care?
Use contact precautions.
Administer ibuprofen prior to assisting with ADLS
Measure rectal temperature every 4 hr.
Administer a stool softener.
The Correct Answer is D
A. Leukemia itself doesn't necessitate contact precautions unless there are other specific infectious concerns, which are not mentioned in this scenario.
B. Ibuprofen is contraindicated in patients with low platelet counts due to the risk of bleeding. Therefore, administering ibuprofen would exacerbate the risk of bleeding in this patient.
C. Invasive procedures like rectal temperature measurements should be avoided in patients with low platelet counts due to the risk of bleeding. Thus, this intervention increases the risk of harm to the patient.
D. Patients with low platelet counts are at risk for bleeding, including gastrointestinal bleeding. Administering a stool softener can help prevent straining during bowel movements, reducing the risk of bleeding and promoting patient comfort and safety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Leukemia itself doesn't necessitate contact precautions unless there are other specific infectious concerns, which are not mentioned in this scenario.
B. Ibuprofen is contraindicated in patients with low platelet counts due to the risk of bleeding. Therefore, administering ibuprofen would exacerbate the risk of bleeding in this patient.
C. Invasive procedures like rectal temperature measurements should be avoided in patients with low platelet counts due to the risk of bleeding. Thus, this intervention increases the risk of harm to the patient.
D. Patients with low platelet counts are at risk for bleeding, including gastrointestinal bleeding. Administering a stool softener can help prevent straining during bowel movements, reducing the risk of bleeding and promoting patient comfort and safety.
Correct Answer is D
Explanation
A. A specific gravity within the normal range indicates adequate urine concentration and hydration status, which is not typically concerning.
B. This color is indicative of normal urine concentration and hydration status and is not necessarily indicative of urinary tract pathology.
C. Absence of glucose in the urine is a normal finding and does not typically warrant further investigation.
D. Microscopic hematuria (blood in the urine not visible to the naked eye) may indicate underlying urinary tract pathology, such as infection, inflammation, or kidney stones, and should be reported to the provider for further evaluation and management.
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