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.)

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.

A. While this statement aims to offer reassurance, it may come off as dismissive of the client’s current feelings. The client is expressing deep emotions, and saying "everything will be okay" may minimize their experience. It’s better to acknowledge their feelings rather than trying to immediately reassure them without understanding the root of their distress.
B. This response invites the client to express their feelings and thoughts but may come off as interrogative or insensitive, especially if the client is already upset. It might not provide the emotional support the client needs in that moment. A better approach would be to validate their emotions first.
C. This response could be perceived as judgmental or sarcastic, potentially making the client feel invalidated or misunderstood. It does not offer the support they need and may discourage them from expressing their feelings further.
D. This response shows empathy and respect for the client’s feelings. By acknowledging their need for space while also expressing a willingness to engage later, the nurse is providing a supportive approach. It allows the client to feel heard and valued without forcing them to communicate when they may not be ready.