The client has developed graft versus host disease (GVHD) during treatment for acute lymphoblastic leukemia (ALL). The client has a generalized pruritic rash on the trunk and the extremities. What nursing measures should the nurse use to address this problem?

Apply bacitracin liberally to the affected areas

Request a medical prescription for diphenhydramine or hydroxyzine

Instruct client to shower with cool water and use a mild soap

Clip fingernails and encourage the use of prescribed lotions

Answer and Explanation

Correct Answer : B,C,D

A.   Bacitracin is an antibiotic ointment typically used to prevent or treat bacterial infections in minor cuts and scrapes. It is not appropriate for treating a pruritic rash associated with GVHD. The rash may not be due to an infection but rather an immune response, so using bacitracin would not address the underlying issue.
B.   Diphenhydramine (Benadryl) and hydroxyzine are antihistamines that can help alleviate itching and provide relief from pruritus. Requesting a prescription for one of these medications is an appropriate response to manage the symptoms of GVHD.
C.   Showering with cool water can soothe irritated skin and reduce itching. Using mild soap helps to avoid further irritation or dryness that harsher soaps can cause. This intervention supports skin care and helps manage pruritus effectively.
D.   Clipping fingernails can help prevent skin damage from scratching, which could lead to secondary infections. Encouraging the use of prescribed lotions can help keep the skin moisturized and alleviate dryness, further addressing the pruritus associated with GVHD.

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Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

Allogeneic Transplant

Matched Donor: This refers to a donor who is not genetically identical to the recipient but has a similar tissue type. This can include unrelated donors who are matched through registries.

Sibling Donor: A sibling can be a potential donor if they have a matching tissue type. Since siblings share genes, there is a higher chance of finding a match.

Autologous Transplant

Self-Donor: In this type of transplant, the patient donates their own stem cells before undergoing treatment (such as chemotherapy or radiation). These cells are then stored and re-infused after treatment to help the body recover.

Syngeneic Transplant

Twin Donor: This involves a donor who is an identical twin. Since identical twins have the same genetic makeup, there is a perfect match, reducing the risk of graft-versus-host disease (GVHD).

A. A serum prolactin level B. An endometrial biopsy C. A Papanicolaou test D. A vaginal ultrasound

Correct Answer is C

Explanation

A. This test is used to measure the level of prolactin, a hormone that stimulates milk production. It is not relevant for cervical cancer screening.
B. This test involves taking a sample of tissue from the lining of the uterus. It is used to diagnose endometrial cancer, not cervical cancer.
C. The Papanicolaou test, commonly known as a Pap smear, is the standard screening test for cervical cancer. It involves collecting cells from the cervix to detect any precancerous changes or cervical cancer itself. This is the correct answer, as it directly relates to cervical cancer screening.
D. This test uses sound waves to create images of the vagina and cervix. It can be used to evaluate the cervix for abnormalities, but it is not as sensitive as a Pap test for detecting cervical cancer.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male 4.51-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-15.5 g/dL
Hematocrit	42% -52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 103/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%
Platelets	150,000-450,000/mm3

The client has developed graft versus host disease (GVHD) during treatment for acute lymphoblastic leukemia (ALL). The client has a generalized pruritic rash on the trunk and the extremities. What nursing measures should the nurse use to address this problem?

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Match the type of bone marrow transplant to the appropriate donor. The nurse is caring for a client who was diagnosed with Acute Myelogenous Leukemia (AML). The client is in need of a bone marrow transplant. Match the type of bone marrow transplant to the appropriate donor:

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

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Correct Answer is C

Explanation

A nurse is caring for a 58-year-old client who is diagnosed with uterine cancer. Which of the following manifestations is likely to be reported by this client?

The client has developed graft versus host disease (GVHD) during treatment for acute lymphoblastic leukemia (ALL). The client has a generalized pruritic rash on the trunk and the extremities. What nursing measures should the nurse use to address this problem?

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