Concepts of Care for Patients with Cancer Flashcard

Front

A client receiving chemotherapy has a white blood cell count of 1,000/mm3. Which of the following should the nurse include in the plan of care?
Options:
Encourage a high-fiber diet,
Provide fresh fruit and vegetables,
Avoid rectal temperatures,
Encourage frequent tooth brushing with a firm toothbrush

Back

Avoid rectal temperatures

Answer explanation

Rectal temps can cause mucosal injury and infection in neutropenic patients.

• Neutropenic patients (low white blood cell count) are at high risk for infection, including from bacteria that might be present in high-fiber foods like raw vegetables, fruits, or undercooked grains.

• A low-fiber or well-cooked diet is recommended to reduce the risk of infection and gastrointestinal complications like bacterial overgrowth or foodborne illnesses.

Fresh fruits and vegetables can contain bacteria and other pathogens that might be harmful to a neutropenic patient, who has a weakened immune system.

• Firm toothbrushes and frequent brushing can cause oral mucosal injury, which can lead to bleeding and increase the risk of infection in a neutropenic patient.

• For oral care, it is recommended to use a soft toothbrush and avoid vigorous brushing. Mouth rinses with saline or a mouthwash specifically designed for neutropenic patients are safer.

Front

A client with terminal lung cancer states, "I'm not afraid to die, I just don't want to leave my family." What is the nurse's best response?

Back

"Tell me more about your concerns."

Answer explanation

This is therapeutic communication, encouraging expression of feelings.

Front

A patient with breast cancer is scheduled for a mastectomy. Which nursing action is most important preoperatively?

Back

Discuss feelings about body image

Answer explanation

Addressing body image and emotional response is a priority in cancer surgery.

Front

A chemotherapy patient calls the clinic reporting a fever of 100.4°F (38°C). What is the nurse's best response?

Back

“Come to the clinic immediately for evaluation.”

Answer explanation

A fever in an immunocompromised patient is a medical emergency.

Front

Which nursing action is most appropriate during the administration of vesicant chemotherapy? Options: Apply ice to the site during infusion, Flush with saline before and after medication, Monitor for urticaria and itching, Use a central venous access device

Back

Use a central venous access device

Answer explanation

Vesicants can cause severe tissue damage; a central line reduces risk of extravasation.

Front

A nurse is caring for a patient with stomatitis related to chemotherapy. Which intervention is appropriate? Options: Provide alcohol-based mouthwash, Encourage frequent mouth rinses with saline, Brush teeth with firm-bristle toothbrush, Offer lemon-glycerin swabs

Back

Encourage frequent mouth rinses with saline

Answer explanation

Saline rinses soothe the mouth and reduce irritation.

Front

A client is newly diagnosed with leukemia. Which lab value is most concerning? Options: Platelet count 30,000/mm³, Hematocrit 36%, Potassium 3.8 mEq/L, WBC 8,000/mm³

Back

Platelet count 30,000/mm³

Answer explanation

Platelets <50,000 put the patient at high risk for bleeding.

Front

Which statement by the client with radiation therapy indicates a need for further teaching? Options: "I can apply lotion to soothe the area after each session."; "I will protect the treatment area from sunlight."; "I won’t scrub or rub the radiation site."; "I’ll wear loose-fitting clothing over the area."

Back

"I can apply lotion to soothe the area after each session."

Answer explanation

Lotions or creams should not be applied unless prescribed, as they may irritate the skin.

Front

What is the priority nursing intervention for a patient receiving immunotherapy who develops shortness of breath and chest tightness?

Back

Stop the infusion and assess vital signs

Answer explanation

Immediate signs of a possible infusion reaction/anaphylaxis require stopping the drug and assessing the patient.

Front

Which of the following can be delegated to a nursing assistant for a cancer patient receiving palliative care? Assess for pain, Monitor for adverse effects of morphine, Provide a bed bath, Educate the family on expected symptoms of dying

Back

Provide a bed bath

Answer explanation

Bed baths and hygiene can be safely delegated.