A nurse is caring for a client who is receiving cisplatin to treat bladder cancer.
After several treatments, the client reports fatigue.
Which of the following actions should the nurse take?
Examine the client for hepatomegaly.
Assess the client for a hypersensitivity reaction.
Check the results of the client's most recent CBC.
Evaluate the client for hypercalcemia.
The Correct Answer is C
Choice A rationale
Examining the client for hepatomegaly can be part of a broader assessment but does not directly address the fatigue related to chemotherapy, particularly cisplatin, which is known to cause bone marrow suppression.
Choice B rationale
Assessing for a hypersensitivity reaction is important during chemotherapy, but it does not specifically address the issue of fatigue, which is often related to blood cell counts.
Choice C rationale
Checking the results of the client's most recent CBC (complete blood count) is crucial because cisplatin can cause anemia, leukopenia, and thrombocytopenia, all of which can lead to significant fatigue.
Choice D rationale
Evaluating for hypercalcemia is not typically associated with cisplatin treatment; it is more relevant in malignancies associated with bone metastasis or overproduction of parathyroid hormone-related protein.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale
Avoiding crowds is to prevent the client from getting infections due to immunosuppression, not to prevent spreading infection to others, thus an incorrect rationale.
Choice B rationale:
Running a toothbrush through a dishwasher may seem hygienic but is generally unnecessary. More effective measures are needed to ensure oral hygiene without excessive sterilization.
Choice C rationale
Antiemetics are typically taken prior to or at the first sign of nausea during chemotherapy, not after the infusion is complete, so this statement is incorrect regarding the timing of antiemetic use.
Choice D rationale
Calling the doctor for unusual menstrual bleeding is crucial as it can indicate thrombocytopenia, a potential side effect of chemotherapy, reflecting the client's correct understanding.
Correct Answer is C
Explanation
Choice A rationale
Replacing the water in flower vases daily does not prevent infection for a client with neutropenia, as bacteria can still accumulate.
Choice B rationale
Humidifying the client’s room can increase the risk of mold growth, which is harmful to immunocompromised clients.
Choice C rationale
Serving cooked fruit minimizes the risk of infections from bacteria and fungi present on raw fruits, which is crucial for clients with low WBC counts.
Choice D rationale
Cleaning dentures in a denture cup does not significantly reduce infection risks for immunocompromised clients; proper mouth hygiene is essential but this practice alone is insufficient.
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