The nurse is caring for a 52-year-old patient with breast cancer ...

[Brittanyd9008]

The nurse is caring for a 52-year-old patient with breast cancer who is receiving chemotherapy with doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan). Which assessment finding is most important to communicate to the health care provider?
 
  a. The patient complains of fatigue.
  b. The patient eats only 25 of meals.
  c. The patient's apical pulse is irregular.
  d. The patient's white blood cell (WBC) count is 5000/L.

Question 2

A patient has had left-sided lumpectomy (breast-conservation surgery) and an axillary lymph node dissection. Which nursing intervention is appropriate to delegate to a licensed practical/vocational nurse (LPN/LVN)?
 
  a. Teaching the patient how to avoid injury to the left arm
  b. Assessing the patient's range of motion for the left arm
  c. Evaluating the patient's understanding of instructions about drain care
  d. Administering an analgesic 30 minutes before scheduled arm exercises

[allisonblackmore]

Answer to Question 1

ANS: C
Doxorubicin can cause cardiac toxicity. The dysrhythmia should be reported because it may indicate a need for a change in therapy. Anorexia, fatigue, and a low-normal WBC count are expected effects of chemotherapy.

Answer to Question 2

ANS: D
LPN/LVN education and scope of practice include administration and evaluation of the effects of analgesics. Assessment, teaching, and evaluation of a patient's understanding of instructions are more complex tasks that are more appropriate to RN level education and scope of practice.