The nurse is caring for a client diagnosed with bladder cancer who is prescribed intravesical immunotherapy. What information should the nurse include in the teaching plan?

Avoid sexual activity for twelve hours

Teach to self-catheterize every 4 hours

Urinate in a sitting position post infusion

Increase fluid intake for 8 hours prior to infusion

Answer and Explanation

The Correct Answer is C

A.   After intravesical therapy, there may be recommendations to avoid sexual activity for a certain period (often 24 hours) to prevent exposure to the medication by a partner. However, the specifics can vary based on the medication used. Twelve hours might not be sufficient depending on the protocol.
B.   Self-catheterization is not routinely required unless there is a specific reason (e.g., urinary retention or difficulty voiding). This statement is not relevant to the therapy itself.
C.   Urinating in a sitting position can help ensure more complete emptying of the bladder and can be safer, particularly for women. It also may minimize contact with any residual medication in the bladder, which can be a consideration post-infusion.
D.   Patients are usually advised to avoid excessive fluid intake immediately before the infusion to prevent bladder distention during the treatment.

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Correct Answer is C

Explanation

A. An ischemic stroke occurs when a blood vessel supplying blood to the brain is obstructed. Common symptoms include sudden numbness or weakness in the face, arm, or leg, confusion, difficulty speaking, and visual disturbances. However, "thunderclap" headache and neck stiffness are not typical symptoms of an ischemic stroke.
B. A TIA, often referred to as a "mini-stroke," produces similar symptoms to a stroke but lasts for a short duration (typically less than 24 hours) and does not cause permanent damage. Symptoms can include weakness, speech difficulties, and visual changes, but again, "thunderclap" headache and neck stiffness are not characteristic of a TIA.
C. A subarachnoid hemorrhage occurs when there is bleeding into the space between the brain and the tissues covering it, often due to a ruptured aneurysm. A "thunderclap" headache, described as an extremely sudden and severe headache, is a hallmark of this condition.
D. A cardioembolic stroke is a type of ischemic stroke that occurs when a blood clot forms in the heart and travels to the brain. Symptoms are similar to those of an ischemic stroke and do not typically include a "thunderclap" headache or neck stiffness.

A. Complaints of pain at the incision B. Increased blood pressure C. Decreased white blood cell count D. Presence of blood on the pillow behind the patient

Correct Answer is D

Explanation

A. While pain can occur post-operatively and may be a sign of complications, it is not a direct indicator of bleeding. Pain can result from normal healing, surgical trauma, or other complications, but by itself, it does not specifically point to bleeding at the surgical site.
B. An increased blood pressure might not necessarily indicate bleeding. In some cases, blood pressure may increase due to pain, anxiety, or other factors. However, a significant drop in blood pressure would be more indicative of bleeding, especially in conjunction with other symptoms.
C. A decreased white blood cell count (leukopenia) is not typically associated with bleeding at the surgical site. In fact, following surgery, one might expect the white blood cell count to be normal or slightly elevated due to the body’s response to surgery.
D. This finding is indicative of bleeding at the surgical site. Blood on the pillow would suggest that there is active bleeding that has escaped from the surgical site, which is a significant concern that requires immediate assessment and intervention.

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The nurse is caring for a client diagnosed with bladder cancer who is prescribed intravesical immunotherapy. What information should the nurse include in the teaching plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client is admitted with complaints of photosensitivity, neck stiffness, and a "thunderclap" headache. The nurse recognizes that these clinical manifestations would present with which type of stroke?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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