A nurse is caring for a 58-year-old client who is diagnosed with uterine cancer. Which of the following manifestations is likely to be reported by this client?
Postmenopausal bleeding
Green, malodorous vaginal discharge
Extreme abdominal pain with intercourse
Swelling on the posterior of the vulva
The Correct Answer is A
A. One of the most common and concerning symptoms of uterine (endometrial) cancer is abnormal vaginal bleeding, particularly postmenopausal bleeding. Any bleeding after menopause is considered abnormal and can be an indicator of uterine cancer, warranting further investigation.
B. While a malodorous vaginal discharge can occur due to infections or other gynecological issues, it is not a primary symptom of uterine cancer. Uterine cancer more commonly presents with bleeding rather than discharge.
C. While some women with advanced uterine cancer may experience pelvic pain or pain during intercourse (dyspareunia), this symptom is not as characteristic or early in the disease process. It is more associated with conditions like endometriosis or pelvic inflammatory disease.
D. This is not a typical manifestation of uterine cancer. While vulvar swelling may be seen in cases of vulvar cancer or infections, it is not a common symptom associated with uterine cancer specifically. Symptoms related to uterine cancer primarily focus on abnormal bleeding.
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Correct Answer is D
Explanation
A. This nurse is already exposed to a significant amount of radiation and should not be assigned to care for another client with an internal radiation implant.
B. Pregnant women should avoid exposure to radiation. This nurse should not be assigned to care for a client with an internal radiation implant.
C. While this nurse has experience with internal radiation, she is still exposed to radiation. It is preferable to assign a nurse who has no prior exposure to internal radiation.
D. This nurse has no prior exposure to internal radiation and is therefore the best candidate to provide care to the client.
Correct Answer is B
Explanation
A.While it's important to gather information about the client's symptoms, the priority in this situation is to determine the underlying cause of the neurological symptoms. A CT scan can quickly identify if there's been a stroke or other brain injury.
B.This is the most appropriate and urgent intervention. A CT scan can rapidly identify if the client has had a stroke, which is a time-sensitive medical emergency. Early diagnosis and treatment are crucial for minimizing brain damage and improving outcomes.
C.t-PA is a medication used to dissolve blood clots in the brain, but it is only effective if given within a specific time window after the onset of stroke symptoms. Without a confirmed diagnosis of stroke from a CT scan, administering t-PA could be harmful.
D.While a speech pathologist may be involved in the client's care later on, the priority is to determine the underlying cause of the neurological symptoms and initiate appropriate treatment. A CT scan is essential for this purpose.
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