A nurse is reviewing the laboratory results of a client who has acute leukemia and received an aggressive chemotherapy treatment 10 days ago. Which of the following hematologic laboratory values should the nurse expect? (Select all that apply.)

Increased hemoglobin count

Decreased leukocyte count

Decreased platelet count

Decreased erythrocyte count

Increased platelet count

Answer and Explanation

Correct Answer : B,C,D

A.   Aggressive chemotherapy often leads to a decrease in red blood cell production due to the suppression of bone marrow activity. Therefore, we would expect a decreased hemoglobin count rather than an increased one.
B.   Chemotherapy targets rapidly dividing cells, which includes not only cancer cells but also normal cells in the bone marrow, leading to a decreased leukocyte (white blood cell) count. This condition is known as leukopenia and increases the risk of infections.
C.   Similar to leukocytes, platelet production is also affected by chemotherapy, resulting in a decreased platelet count (thrombocytopenia). This can lead to increased bleeding risk and bruising.
D.   Chemotherapy can cause a decrease in erythrocytes (red blood cells) due to its impact on the bone marrow. This is part of the broader condition known as anemia, which is common in patients undergoing aggressive cancer treatments.
E.   Following aggressive chemotherapy, we would not expect an increased platelet count. Instead, the count is typically decreased due to the effects of the treatment on the bone marrow.

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Correct Answer is D

Explanation

A. A specialized chemotherapy mask is not typically required for the administration of oral chemotherapy. Masks may be necessary during certain procedures (like administering intravenous chemotherapy) where there is a risk of splashing or aerosolization, but they are not standard for oral administration.
B. A chemotherapy gown is generally not required for administering oral chemotherapy. These gowns are used for intravenous chemotherapy administration where there is a risk of drug spillage. For oral medications, the risk of exposure is significantly lower, so gowns are not standard practice.
C. A face shield is not typically needed when administering oral chemotherapy. Face shields are used to protect against splashes during procedures involving injectable forms of chemotherapy or other hazardous drugs, but oral administration does not pose the same risk of exposure.
D. The use of chemotherapy gloves is essential when handling oral chemotherapy agents. Gloves protect the nurse from potential exposure to the medication, especially if the drug is crushed or if there is any risk of spillage.

A. Neutropenic B. Bleeding C. Droplet D. Contact

Correct Answer is B

Explanation

A. Neutropenic precautions are necessary for patients with low white blood cell counts (neutrophils), which increases the risk of infections. However, in this scenario, the child has a critically low platelet count, not necessarily low white blood cells.
B. This option refers to implementing bleeding precautions, which are critical for a child with low platelet counts (thrombocytopenia). This includes measures to prevent injury and bleeding, such as avoiding invasive procedures, using soft toothbrushes, and ensuring a safe environment.
C. Droplet precautions are used to prevent the spread of infections transmitted through respiratory droplets, such as influenza or COVID-19. While important for specific infections, this does not apply directly to the child's condition regarding leukemia and low platelets unless there is a concern for a respiratory illness.
D. Contact precautions are used to prevent the spread of infections through direct contact with the patient or their environment. This is important for infections that can be spread by touch. However, it is not the primary concern for a child with low platelet counts unless there is a known infectious risk.

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A nurse is reviewing the laboratory results of a client who has acute leukemia and received an aggressive chemotherapy treatment 10 days ago. Which of the following hematologic laboratory values should the nurse expect? (Select all that apply.)

Nursing Test Bank

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