NURS 2207 Oncology Evolve EAQ (Graded) - Questions, Answers and Rationales Which response would the nurse offer when a client undergoing brachytherapy fo... [Show More] r breast cancer asks what precautions need to be observed? 1. "There are no restrictions during your brachytherapy." 2. "All body fluid during therapy is treated as radioactive." 3. "You should maintain contact isolation during treatment." 4. "Visitors should be limited, particularly pregnant women and children." Rationale: Visitors should be limited, particularly pregnant women and children, during brachytherapy, although the radiation risk is very low. The restriction includes limiting visitors. Body fluid is not radioactive from brachytherapy. Contact isolation is not required with brachytherapy. The nurse teaches a client who is scheduled to receive intravenous chemotherapy for ovarian cancer about the use of imagery to maximize the effects of the chemotherapy and reduce the side effects. Which statement would the nurse use regarding this alternative therapy? 1. "Rest your mind while remaining in the present." 2. "Listen to soothing instrumental music during the infusion." 3. "Light a candle with the scent of lavender during the infusion." 4. "Focus on the droplets of chemotherapy attacking the cancer cells." Rationale: Imagery is the application of the conscious use of the power of imagination with the intention of activating biological, psychological, and spiritual healing. The individual creates mental pictures of the desired outcome from memories, dreams, fantasies, and hopes. Meditation, not imagery, quiets the mind and focuses on the present to release fears, worries, anxieties, and doubts concerning the past and the future. Music therapy, not imagery, aligns the body, mind, and spirit with its own fundamental frequency, which brings about changes in emotions and functioning. Aromatherapy, not imagery, uses essential oils to stimulate the olfactory receptors and ultimately the brain, where many believe the products influence emotions, memory, and a variety of bodily functions such as heart rate, blood pressure, breathing, and immune responses. When a client is admitted with thrombocytopenia, which nursing actions would be included in the plan of care? Select all that apply. One, some, or all responses may be correct. 1. Avoid intramuscular injections. 2. Institute neutropenic precautions. 3. Monitor the white blood cell (WBC) count. 4. Administer prescribed anticoagulants. 5. Examine the skin for ecchymotic areas. Rationale: Intramuscular injections should be avoided because of the increased risk of bleeding and possible hematoma formation. Decreased platelets increase the risk of bleeding, which leads to ecchymoses. Neutropenic precautions are for clients with decreased WBCs, not platelets. Platelet count, rather than WBC count, will be monitored. Anticoagulants are contraindicated because of the increased bleeding risk. A client who is in a late stage of pancreatic cancer intellectually understands the terminal nature of the illness. Which behaviors indicate the client is emotionally accepting the impending death? 1. Revising the client's will and planning a visit to a friend 2. Alternately crying and talking openly about death 3. Getting second, third, and fourth medical opinions 4. Refusing to follow treatments and stating they won't help anyway Rationale: Revising the will and planning a visit to a friend are realistic, productive, and constructive ways of using this time. Crying and talking openly about death are signs of depression. Going from health care provider to health care provider demonstrates disbelief, denial, or desperation. Refusing to follow treatments and stating that the client is going to die anyway indicates anger and hopelessness, not acceptance. A client is scheduled for radiation treatments Monday through Friday. The client asks why the treatments will not be given on Saturday and Sunday. Which is the nurse's best response? 1. "This type of schedule gives noncancerous cells time to recover." 2. "The department only operates from Monday through Friday." 3. "Your energy level will be increased greatly by a 5-day schedule." 4. "Side effects are eliminated when treatment is administered for 5 rather than 7 days." Rationale: Both malignant and healthy cells are affected by radiation; time between courses of treatment allows normal cells to repair. Staff are available if necessary for a treatment protocol; some facilities operate 7 days a week. Fatigue occurs in either a 5- or 7-day schedule. Some side effects are inevitable, although they vary with each individual; they cannot be eliminated. When a client who has seemed cheerful after a diagnosis of lung cancer and pneumonectomy becomes withdrawn after being discharged home, which action by the home health nurse will be best? [Show Less]
