The nurse is administering medications to the client and is monitoring potential adverse effects of medications.

For each body system below, click to specify the assessment findings that could indicate a serious adverse reaction. Each body system may support more than 1 potential assessment finding. To deselect a finding click on the finding again.

Body system	Findings
Head. Eyes. Ears. Nose, and Throat (HEENT)	Yellowing of the eyes Blurred vision Dry eyes
Gastrointestinal	Abdominal pain Weight gain
Hematologic	Increased bruising Increased bleeding tendancies Insomnia
Genitourinary	Darkening of the urine Urinary frequency

A) Two diarrhea stools in the last day: Diarrhea, especially if it is mild and without other severe symptoms, is not a contraindication for receiving a varicella vaccine. The child may still be able to receive the immunization if they are otherwise well. However, if the diarrhea is accompanied by fever, vomiting, or other signs of illness, the vaccine may be delayed.

B) Chemotherapy treatments: Chemotherapy treatments are a contraindication for the varicella vaccine. Chemotherapy can suppress the immune system, making the child more vulnerable to infections, including the risk of contracting varicella from the live vaccine. Immunocompromised patients should not receive live vaccines unless approved by their healthcare provider.

C) Clear rhinorrhea: Clear rhinorrhea, or a runny nose, typically indicates a mild upper respiratory condition like a cold. This is not a contraindication for receiving the varicella vaccine unless other symptoms are more severe or the child has a fever or signs of a more serious illness.

D) Medications for a cardiac anomaly: Medications for a cardiac anomaly do not generally interfere with the safety of the varicella vaccine. These medications may require careful monitoring for other reasons, but they are not contraindications to receiving the immunization, as long as the child is not immunocompromised from other causes

A) "My husband won't need medication for breakthrough pain while using music therapy."
This statement is incorrect. While music therapy can help reduce pain perception and provide comfort, it is not a replacement for medications, especially for breakthrough pain. Breakthrough pain may still occur, and medications are often needed to manage it. Music therapy can complement the use of pain medications, but it does not eliminate the need for them.

B) "Playing music will increase my husband's alertness."
This statement is not accurate. Music therapy may enhance relaxation, reduce anxiety, and help manage pain, but it is not generally used to increase alertness in terminally ill patients. In fact, some music therapy techniques may be calming and soothing, which could encourage rest rather than increasing alertness.

C) "I will discontinue music therapy when my husband is no longer responsive."
This statement is incorrect. Music therapy can still be beneficial even if the client becomes less responsive. In hospice care, music therapy is often used to provide comfort, promote relaxation, and offer emotional support, even for clients who are less alert or responsive. Discontinuing therapy may deprive the client of a source of comfort.

D) "Music will distract my husband's awareness of the pain."
This statement is correct. Music therapy can serve as a distraction and help reduce the client's perception of pain by focusing their attention away from discomfort. It can promote relaxation, reduce anxiety, and alter the client's awareness of their pain, making it an effective complementary treatment for pain management in hospice care.