A nurse is providing discharge teaching to a client who has an impaired immune system due to chemotherapy. Which of the following information should the nurse include in the teaching?
"Change the water in your drinking glass every 4 hours."
"Change your pet's litter box daily."
"Wash your toothbrush in the dishwasher once each month."
"Wash your perineal area two times each day with antimicrobial soap."
The Correct Answer is D
The client should wash their perineal area twice a day with antimicrobial soap to prevent infection and irritation. This is especially important for clients who have an impaired immune system due to chemotherapy, as they are more susceptible to infections and complications.
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Related Questions
Correct Answer is B,A,C,D
Explanation
The nurse should first check for contraindications to tPA, such as hemorrhagic stroke, recent surgery, bleeding disorder, or uncontrolled hypertension. Then, the nurse should weigh the client to calculate the correct dose of tPA based on body weight. Next, thenurse should administer the tPA within three hours of symptom onset to improve the chances of recovery. Finally, the nurse should transfer the client to the CCU for close monitoring of vital signs, neurological status, and possible complications.
Correct Answer is A
Explanation
The nurse's priority is to ensure that the client has given informed consent for the surgery, which requires that the client is competent and understands the risks and benefits of the procedure. A client with a high blood alcohol level may not have the mental capacity to consent and may need a legal representative or a court order to proceed with the surgery.
The other actions are important but not as urgent as obtaining consent.
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