A nurse is caring for a client who is receiving cisplatin for the treatment of ovarian cancer. The client's most recent complete blood count (CBC) is shown in the table below. It is important for the nurse to consider which of the following for the client?
- WBC: 1,400/mm³
- RBC: 4.3 x 10¹²/L
- Hgb: 12.1 g/dL
- Hct: 36.5%
- Platelets: 170,000/mm³
- Albumin: 4.5 g/dL
Given the options:
The client should receive an erythropoiesis-stimulating agent.
The client should receive a diet with increased protein.
The client has an increased risk of infection.
The client has an increased risk for bleeding.
The Correct Answer is C
Choice A reason: The use of erythropoiesis-stimulating agents (ESAs) is indicated for anemia due to chemotherapy¹. However, the client's hemoglobin (Hgb) level is 12.1 g/dL, which is within the normal range (normal: 12-15.5 g/dL for women). Therefore, administering an ESA is not indicated based on the Hgb level provided.
Choice B reason: A diet with increased protein can be beneficial for patients undergoing chemotherapy as it helps in tissue repair and immune system function. However, the client's albumin level is 4.5 g/dL, which falls within the normal range (normal: 3.4-5.4 g/dL), suggesting adequate protein intake. Thus, there is no indication that the client requires an increased protein diet based on the albumin level provided.
Choice C reason: The client's white blood cell (WBC) count is 1,400/mm³, which is below the normal range (normal: 4,500-11,000/mm³). This condition, known as leukopenia, significantly increases the risk of infection³. Therefore, the nurse should prioritize monitoring for signs of infection and implementing infection control measures.
Choice D reason: The client's platelet count is 170,000/mm³, which is within the normal range (normal: 150,000-450,000/mm³). Although cisplatin can cause thrombocytopenia, the current platelet count does not indicate an increased risk for bleeding⁴. Therefore, this choice is not correct based on the platelet count provided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Hemodialysis does not typically result in a significant decrease in RBC count. While there can be a minimal loss of red blood cells during the process, it is not the primary focus of the treatment. The main purpose of hemodialysis is to remove waste products and excess fluid from the blood when the kidneys are not functioning properly.
Choice B reason:
Calcium levels may vary during hemodialysis, and the treatment can be adjusted to prevent significant changes in calcium levels. Hemodialysis can remove some calcium from the blood, but it is usually not the most affected value, and calcium can be added to the dialysate solution if necessary.
Choice C reason:
Potassium is one of the primary electrolytes removed during hemodialysis. High levels of potassium, which can be life-threatening, are commonly seen in clients with renal failure. Hemodialysis effectively reduces high potassium levels, which is crucial for preventing complications such as cardiac arrhythmias.
Choice D reason:
Protein levels are not directly targeted by hemodialysis, and significant protein loss is not a usual outcome of the treatment. The dialysis membrane is designed to allow smaller molecules like urea and potassium to pass through while retaining larger molecules like proteins.
Correct Answer is C
Explanation
Choice A reason:
Skin traction is indeed less restrictive than skeletal traction, allowing for more mobility. It is applied using bandages or adhesive material to the skin, which can be removed or adjusted more easily than the pins or screws used in skeletal traction. This type of traction is typically used for short-term treatment before surgery or when the injury is less severe.
Choice B reason:
Discomfort levels can vary depending on the individual and the specific circumstances of the traction. However, skin traction is generally considered to be less painful than skeletal traction because it is less invasive and applies less force. Skeletal traction, which involves the insertion of pins or wires directly into the bone, is likely to cause more discomfort due to the invasive nature of the procedure.
Choice C reason:
Skeletal traction is more appropriate for reducing fractures, especially in cases where a greater force is needed to align the bones. It involves the surgical insertion of pins or wires directly into the bone, allowing for a stronger and more stable pull that is necessary for the realignment of complex fractures.
Choice D reason:
Skeletal traction carries a higher risk of infection compared to skin traction because it is more invasive. The insertion of pins or wires into the bone creates a potential entry point for bacteria, which can lead to infection at the site of insertion.
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