A nurse assesses a client who is prescribed 5-fluorouracil (5-FU) ...

[nelaaney]

A nurse assesses a client who is prescribed 5-fluorouracil (5-FU) chemotherapy intravenously for the treatment of colon cancer. Which assessment finding should alert the nurse to contact the health care provider?
 
  a. White blood cell (WBC) count of 1500/mm3
  b. Fatigue
  c. Nausea and diarrhea
  d. Mucositis and oral ulcers

Question 2

A nurse assesses a client with a mechanical bowel obstruction who reports intermittent abdominal pain. An hour later the client reports constant abdominal pain. Which action should the nurse take next?
 
  a. Administer intravenous opioid medications.
  b. Position the client with knees to chest.
  c. Insert a nasogastric tube for decompression.
  d. Assess the client's bowel sounds.

[kristenb95]

Answer to Question 1

ANS: A
Common side effects of 5-FU include fatigue, leukopenia, diarrhea, mucositis and mouth ulcers, and peripheral neuropathy. However, the client's WBC count is very low (normal range is 5000 to 10,000/mm3), so the provider should be notified. He or she may want to delay chemotherapy by a day or two. Certainly the client is at high risk for infection. The other assessment findings are consistent with common side effects of 5-FU that would not need to be reported immediately.

Answer to Question 2

ANS: D
A change in the nature and timing of abdominal pain in a client with a bowel obstruction can signal peritonitis or perforation. The nurse should immediately check for rebound tenderness and the absence of bowel sounds. The nurse should not medicate the client until the provider has been notified of the change in his or her condition. The nurse may help the client to the knee-chest position for comfort, but this is not the priority action. The nurse need not insert a nasogastric tube for decompression.

[nelaaney]

Thank you

[kristenb95]

Happy to help you