A nurse is providing discharge teaching to a client who has acute leukemia and received chemotherapy 12 hours ago. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Choice A Reason:

Respiratory therapy is not typically required for clients with chronic kidney disease unless they have concurrent respiratory issues. CKD primarily affects the kidneys and related systems, so respiratory therapy is not a standard referral for these patients.

Choice B Reason:

Hospice care is generally reserved for clients with terminal illnesses who are nearing the end of life. While CKD can be a serious condition, many clients manage it with appropriate treatment and lifestyle changes. Therefore, hospice care is not a standard referral for newly diagnosed CKD patients.

Choice C Reason:

Occupational therapy may be beneficial for clients with CKD who experience difficulties with daily activities due to fatigue or other symptoms. However, it is not the most immediate or essential referral upon initial diagnosis.

Choice D Reason:

Dietary services are crucial for clients with chronic kidney disease. Proper nutrition can help manage symptoms, slow disease progression, and improve overall health. A dietitian can provide personalized dietary plans to ensure the client avoids foods that may exacerbate their condition and includes those that support kidney health.

Choice A Reason

“Your provider will use stool from your digital rectal examination to perform the test.” This statement is incorrect. For fecal occult blood testing, stool samples are typically collected at home using a special kit provided by the healthcare provider. The samples are then sent to a lab for analysis. Using stool from a digital rectal examination is not the standard procedure for FOBT.

Choice B Reason

“Your provider will prescribe a stimulant laxative prior to the procedure to evacuate the bowel.” This statement is incorrect. Stimulant laxatives are not typically prescribed before an FOBT. The test requires a small sample of stool, and using a laxative could interfere with the results. Patients are usually advised to follow specific dietary and medication guidelines to avoid false positives or negatives.

Choice C Reason

“You should begin annual fecal occult blood testing for colorectal cancer screening at 40 years old.” This statement is incorrect. Current guidelines recommend starting colorectal cancer screening, including FOBT, at age 45 for individuals at average risk. Screening may start earlier for those with a higher risk, such as a family history of colorectal cancer.

Choice D Reason

“You should avoid taking corticosteroids prior to testing.” This is the correct statement. Corticosteroids can cause gastrointestinal irritation and bleeding, which may lead to false-positive results in fecal occult blood tests. Therefore, it is important to avoid these medications before testing.