Oncology

1. The nurse is caring for a client with lung cancer and bone metastasis. What signs and symptoms would the nurse recognize as indications of a possible oncological emergency? Select all that apply.

• Facial edema in the morning

• Weight loss of 20 lb (9 kg) in 1 month

• Serum calcium level of 12 mg/dL (3.0 mmol/L)

• Serum sodium level of 136 mg/dL (136 mmol/L)

• Numbness and tingling of the lower extremities

A client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the cancer. The nurse anticipates that the health care provider will request which prescriptions? Select all that apply.

• Radiation

• Chemotherapy

• Increased fluid intake

• Serum sodium level determination

• Medication that is antagonistic to anti-diuretic hormone

The nurse is monitoring a client for signs and symptoms related to superior vena cava syndrome. Which is an early sign of this oncological emergency?

• Cyanosis

• Arm edema

• Periorbital edema

• Mental status changes

As part of chemotherapy education, the nurse teaches a female client about the risk for bleeding and self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement?

• "I should avoid blowing my nose."

• "I may need a platelet transfusion if my platelet count is too low."

• "I'm going to take aspirin for my headache as soon as I get home."

• "I will count the number of pads and tampons I use when menstruating."

The nurse is caring for a client following a mastectomy. Which nursing intervention would assist in preventing lymphedema of the affected arm?

• Placing cool compresses on the affected arm

• Elevating the affected arm on a pillow above heart level

• Avoiding arm exercises in the immediate postoperative period

• Maintaining an intravenous site below the antecubital area on the affected side

The nurse is reviewing the laboratory test results for a client with a diagnosis of leukemia who is receiving chemotherapy. The nurse notes that the client's platelet count is 20,000 mm3 (200 × 109/L). The nurse should prepare to implement which action based on this finding?

• Remove the fresh flowers from the client's room.

• Remove the rectal thermometer from the client's room.

• Instruct family members to wear a mask when entering the client's room.

• Call the dietary department to report that the client will be on a low-bacteria diet.

A patient with a diagnosis of lung cancer is receiving chemotherapy and reports nausea and loss of appetite resulting in decreased food intake. What should the healthcare provider recommend to promote adequate nutrition? Advise the patient to:

• Eat only favorite foods to increase appetite.

• Eat small, high-calorie meals throughout the day.

• Eat large meals less frequently throughout the day.

• Eat when you are feeling hungry.

The nurse is reviewing the laboratory test results for a client with bladder cancer with bone metastasis. The nurse should contact the health care provider (HCP) if which finding is noted?

• Calcium level of 15 mg/dL (3.75 mmol/L)

• Potassium level of 3.8 mEq/L (3.8 mmol/L)

• Platelet count of 200,000 mm3

• White blood cell (WBC) count of 6000 mm3

The nurse is reviewing the laboratory test results for a client receiving chemotherapy. The nurse notes that the white blood cell count is extremely low and places the client on neutropenic precautions. Which interventions are components of these types of precautions? Select all that apply.

• Allowing only fresh fruits in the client's room

• Removing fresh-cut flowers from the client's room

• Encouraging the client to eat any types of fresh vegetables

• Instructing family members on the proper technique for hand washing

• Instructing family members to wear a mask when entering the client's room

The nurse is caring for a client with leukemia who is receiving intravenous chemotherapy. The nurse reviews the laboratory results and notes that the white blood cell count is 2000 mm3, the platelet count is 150,000 mm3, the clotting time is 10 minutes, and the ammonia level is 20 mcg/dL. Which nursing action would be appropriate?

• Place the client on bleeding precautions.

• Place the client on neutropenic precautions.

• Remove the rectal thermometer from the client's room.

• Instruct the dietary department to eliminate all proteins from the client's diet.