Which explanation will the nurse give a patient with non-Hodgkin lymphoma about the purpose of a planned lumbar puncture?

Choice A rationale:

Flossing using thick tape floss can cause trauma to the gums and may lead to bleeding in patients with thrombocytopenia. Patients with low platelet counts are at risk of excessive bleeding from minor injuries, and using thick tape floss could potentially harm the gums and exacerbate bleeding.

Choice B rationale:

Shaving using an electric razor is a safe option for patients with thrombocytopenia. Electric razors do not pose a significant risk of cuts or nicks, reducing the likelihood of bleeding, which is crucial for patients with low platelet counts.

Choice C rationale:

Wearing flip-flops to go walking may not be the safest option for a patient with thrombocytopenia. If the patient accidentally stubs their toe or injures their foot while wearing flip-flops, it could lead to bleeding. Closed-toe, comfortable shoes provide better protection against foot injuries.

Choice D rationale:

Brushing using a stiff-bristle toothbrush can be harmful to the gums, especially for patients with thrombocytopenia. Stiff-bristle toothbrushes can cause gum irritation and bleeding. Patients with low platelet counts should use a soft-bristle toothbrush to minimize the risk of gum injury.

The correct answer is Choice D. Then start with Choice A rationale:

Choice A is incorrect because it representsmetabolic alkalosis, not respiratory alkalosis. Metabolic alkalosis occurs when there is a primary increase in the bicarbonate (HCO3) level, which causes the pH to rise above the normal range (7.35-7.45). The PaCO2 is normal in this case, indicating that the respiratory system is not involved in the acid-base imbalance.Some causes of metabolic alkalosis include vomiting, diuretic use, excessive antacid intake, and mineralocorticoid excess1.

Choice B is incorrect because it representsrespiratory acidosis, not respiratory alkalosis. Respiratory acidosis occurs when there is a primary decrease in the PaCO2 level, which causes the pH to fall below the normal range. The HCO3 is normal in this case, indicating that the metabolic system is not involved in the acid-base imbalance.Some causes of respiratory acidosis include hypoventilation, airway obstruction, chest trauma, neuromuscular disorders, and chronic lung diseases2.

Choice C is incorrect because it representsmetabolic acidosis, not respiratory alkalosis. Metabolic acidosis occurs when there is a primary decrease in the HCO3 level, which causes the pH to fall below the normal range. The PaCO2 is normal in this case, indicating that the respiratory system is not involved in the acid-base imbalance.Some causes of metabolic acidosis include diabetic ketoacidosis, lactic acidosis, renal failure, diarrhea, and poisoning3.

Choice D is correct because it representsrespiratory alkalosis. Respiratory alkalosis occurs when there is a primary decrease in the PaCO2 level, which causes the pH to rise above the normal range. The HCO3 is normal in this case, indicating that the metabolic system is not involved in the acid-base imbalance. Some causes of respiratory alkalosis include hyperventilation, anxiety, panic, fever, pain, tumor, trauma, severe anemia, liver disease, overdose of certain medicines, pulmonary embolism, pregnancy, and any lung disease that leads to shortness of breath . Respiratory alkalosis is characterized by symptoms such as breathlessness, dizziness, numbness, tingling, muscle spasms, chest discomfort, confusion, and fainting.