A nurse is caring for a client who has myelosuppression after receiving chemotherapy. The nurse should monitor the client for which of the following adverse effects?
Anorexia and malnutrition
Diarrhea and dehydration
Bleeding from the gums
Full body alopecia
The Correct Answer is C
A. Anorexia and malnutrition - While these may occur due to chemotherapy, they are not directly caused by myelosuppression.
B. Diarrhea and dehydration - These symptoms might be side effects of chemotherapy but are not specific to myelosuppression.
C. Bleeding from the gums - Myelosuppression can lead to thrombocytopenia (low platelet count), increasing the risk of bleeding, including from gums and other mucous membranes.
D. Full body alopecia - Alopecia is a common side effect of chemotherapy but is not related to myelosuppression.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Stop the infusion of blood. The client’s symptoms suggest a possible acute hemolytic transfusion reaction, which is a life-threatening emergency. The first and most critical action is to stop the blood transfusion immediately to prevent further reaction and additional hemolysis.
B. Inform the provider: This is an important action but should be done after stopping the transfusion to prevent further complications.
C. Obtain a urine specimen: This is done to check for hemoglobinuria, but it is not the immediate priority.
D. Notify the laboratory: This is part of the follow-up procedure but should be done after stopping the transfusion and stabilizing the patient.
Correct Answer is A
Explanation
A. Hemolytic: Acute hemolytic transfusion reactions can occur quickly after starting a transfusion and present with symptoms such as fever, chills, headache, low back pain, tachycardia, and apprehension. It is a serious reaction caused by the destruction of transfused red blood cells.
B. Allergic: Allergic reactions to blood transfusions typically present with hives, itching, and anaphylaxis, not low back pain or tachycardia.
C. Febrile: Febrile reactions involve fever and chills but not typically headache or back pain.
D. Bacterial: Bacterial contamination of blood can cause fever and chills, but not specifically the symptoms of headache and low back pain described.
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