Keeping follow-up appointments is important for all clients. Without knowing what antibioticwas prescribed, the nurse cannot instruct the client on how to take it.Q:When teaching a patient about the treatment of acoustic neuroma, the nurse will includeinformation abouta.a low sodium diet.b.ways to avoid falls.c.how to apply sunscreen.d.the chemotherapy side effects.Intermittent vertigo occurs with acoustic neuroma, so the nurse should include information abouthow to prevent falls. Diet is not a risk factor for acoustic neuroma and no dietary changes are
needed. Sunscreen would be used to prevent skin cancers on the external ear. Acoustic neuromasare benign and do not require chemotherapy.Care of Patients with Hematologic ProblemsWhite Blood Cell DisordersLeukemiaHodgkin’s/NonHodgkin’s Disease
Patient teaching:o Avoid crowds & ill peopleo Don’t share toiletrieso Wash armpits, groin, genital & anal area twice a dayw/antimicrobial soapo Clean toothbrush daily by running through dishwashero Don’t drink water that’s been standing for longer than 15minso Take temp twice a dayo Avoid changing pet litter boxesoEat low bacteria diet & avoid salads, raw fruits & vegetables & undercooked meato Don’t reuse cups w/o washing• Complicationso Infection7.An appropriate nursing intervention for a patient with non-Hodgkin’s lymphoma whoseplatelet count drops to 18,000 during chemotherapy is toa.Check all stools for occult bloodb.Encourage fluids to 3000 mL/dayc.Provide oral hygiene every 2 hoursd.Check the temperature every 4 hoursMultiple MyelomaPlatelet disorder: thrombocytopenia:↓platelets (↑RISK FOR BLEEDING)- TWO TYPESo(1) Autoimmune thrombocytopenia purpura “idiopathic”▪Manifestations: INITIAL FINDING large ecchymoses, petechial rash (arms, legs,upper chest, neck), & mucosal bleeding; may have anemia
o(2) Thrombotic thrombocytopenia purpura▪Manifestations: inappropriate clotting, unable to clot w/ trauma- Patient teachingoDo not shaveoDo not brush teeth aggressively(11) Platelet transfusionless than 10,000 is a life-threatening situation(12) Splenectomy has a high risk for infection and you want them to have avaccination done two weeks before and after(13) Thrombocytopenic purpura - platelets are clumped together – remove and givenew fresh frozen plasma(14) Hemophelia- bleeding disorder- (not also into the factor) know the labs what iselevated for hemophilia and what is not elevated- excessive bleeding- Labs:↑apt (Plt count & PT normal)8.A client with multiple myeloma has been started on filgrastim (Neupogen) for treatmentof neutropenia. The nurse identifies the drug is being effective when:a.The client no longer has bone painb.The client is no longer hypotensivec.An increase in the white blood cell count occursd.The hemoglobin level is within normal limitsgastritis9.A patient with chronic gastritis says, “I’ve stopped taking the medication because I feelso much better now that I drink ginger tea.” The nurse realizes that this patient:a.Cannot afford the medicationb.Is in denial of the diseasec.Is using a complementary therapy for the symptomsd.
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