A nurse is creating a plan of care for a client who has cancer and is experiencing Immunosuppression. Which of the following Interventions should the nurse include in the plan of care?
Monitor the client's vital signs every 12 hr.
Inspect the client's mouth every 8 hr.
Provide fresh fruit with the client's meals.
Rotate health care staff caring for the client.
The Correct Answer is B
A. Monitoring vital signs every 12 hours is a standard nursing intervention but may not specifically address the needs of a client with immunosuppression.
B. Inspecting the client's mouth every 8 hours can help in early detection of mouth sores or infections, which are common in immunosuppressed individuals.
C. Providing fresh fruit with meals may not be appropriate for a client with immunosuppression, as fresh fruits can harbor pathogens that pose a risk of infection.
D. Rotating healthcare staff caring for the client helps increases the risk of introducing pathogens to the client. This increases the risk of infection in the immunosuppressed client.
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Related Questions
Correct Answer is D
Explanation
A. Milk products can exacerbate symptoms of irritable bowel syndrome in some individuals, especially those with lactose intolerance, and are generally not recommended.
B. Foods sweetened with fructose corn syrup may exacerbate symptoms of irritable bowel syndrome in some individuals and are best avoided.
C. Gluten-containing foods may trigger symptoms in individuals with irritable bowel syndrome, particularly those with gluten sensitivity or celiac disease, and should be limited or avoided as appropriate.
D. Increasing intake of foods high in bran fiber can help regulate bowel movements and alleviate symptoms of constipation, which is often a concern for individuals with irritable bowel syndrome.
Correct Answer is A
Explanation
A. Newborn genetic screening is typically performed after 24 hours of age to ensure accurate results and allow for the detection of certain genetic conditions.
B. Newborn genetic screening is typically performed only once, shortly after birth, and is not routinely repeated at 2 months of age.
C. Newborn genetic screening does not typically require the baby to drink water prior to the test.
D. While blood is drawn from the baby for genetic screening, it is typically obtained from the baby's heel, not the inner elbow.
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