The nurse is giving discharge instructions to a patient on the medical-surgical unit. Which patient should be taught about the possibility of an overwhelming infection?

Post chemotherapy

Diagnosed with sickle cell anemia

Diagnosed with multiple myeloma

Post-splenectomy patient

Answer and Explanation

The Correct Answer is D

A.   While patients receiving chemotherapy are at risk for infections due to immunosuppression, the risk of overwhelming infection, particularly from encapsulated bacteria, is higher in post-splenectomy patients due to impaired immune function without the spleen.
B.   Patients with sickle cell anemia are at increased risk of infections, particularly from encapsulated bacteria, due to functional asplenia or hyposplenism, but the risk of overwhelming infection is highest in post-splenectomy patients.
C.   Patients with multiple myeloma are immunocompromised and at increased risk of infections, but they do not have the same risk of overwhelming infection as post- splenectomy patients.
D.   Post-splenectomy patients are at highest risk of overwhelming infection due to impaired immune function resulting from the absence of the spleen, which plays a crucial role in immune surveillance and defense against encapsulated bacteria.

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Correct Answer is ["B","C","D","E","G","H"]

Explanation

A. Polycythemia (an abnormally high red blood cell count) is not typically a primary concern in dialysis patients; instead, they are more often monitored for anemia.
B. Dialysis patients often need to restrict fluid intake to prevent fluid overload, which can exacerbate edema and cause additional cardiovascular strain.
C. Daily weight monitoring is crucial for dialysis patients to track fluid balance and detect any sudden changes that might indicate fluid retention or loss.
D. Frequent oral care is important to prevent infections, particularly because dialysis patients are at increased risk due to their compromised immune systems and possible fluid restrictions, which can lead to dry mouth and other oral health issues.
E. Dialysis patients may need a modified protein intake, depending on their specific needs and the type of dialysis (hemodialysis vs. peritoneal dialysis). Protein needs can vary, so it is essential to follow the specific dietary recommendations provided by a healthcare provider.
F. Avoiding nephrotoxic substances (e.g., certain medications, contrast dyes) is critical to protect the remaining kidney function and prevent further damage.
G. A low-sodium diet helps manage blood pressure and fluid balance, reducing the risk of fluid retention and hypertension in dialysis patients.

H. Monitoring urine output is important to assess kidney function and fluid balance.

Even though dialysis takes over some kidney functions, any remaining urine output can provide valuable information about the patient's residual kidney function.

A. Urine specific gravity 1.020 B. Amber yellow urine color C. Absence of glucose in the urine D. Microscopic hematuria

Correct Answer is D

Explanation

A. A specific gravity within the normal range indicates adequate urine concentration and hydration status, which is not typically concerning.
B. This color is indicative of normal urine concentration and hydration status and is not necessarily indicative of urinary tract pathology.
C. Absence of glucose in the urine is a normal finding and does not typically warrant further investigation.
D. Microscopic hematuria (blood in the urine not visible to the naked eye) may indicate underlying urinary tract pathology, such as infection, inflammation, or kidney stones, and should be reported to the provider for further evaluation and management.

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The nurse is giving discharge instructions to a patient on the medical-surgical unit. Which patient should be taught about the possibility of an overwhelming infection?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a 32-year-old female patient coming to the clinic with peripheral edema, periorbital edema, and flank pain. Use the chart to answer the questions. Exhibits Which items should the nurse include when teaching the patient and family about dialysis? Select all that apply.

Correct Answer is ["B","C","D","E","G","H"]

Explanation

A nurse is reviewing the urinalysis results of a client who reports urinary frequency and burning. Which of the following findings should the nurse report to the provider?

Correct Answer is D

Explanation

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The nurse is giving discharge instructions to a patient on the medical-surgical unit. Which patient should be taught about the possibility of an overwhelming infection?

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