The nurse is caring for an 8-year-old girl who has been diagnosed ...

[Jipu 123]

The nurse is caring for an 8-year-old girl who has been diagnosed with leukemia and will have a variety of tests, including a lumbar puncture, before beginning chemotherapy. Which of the following would be the priority?
 
  A) Applying EMLA to the lumbar puncture site
  B) Educating the child and family about the testing procedures
  C) Administering promethazine as ordered for nausea
  D) Educating the family about chemotherapy and its side effects

Question 2

The nurse is caring for a 16-year-old boy with acute myelogenous leukemia who is having chemotherapy and who has incomplete records for varicella zoster immunization. Which of the following will be the priority nursing diagnosis?
 
  A) Pain related to adverse effects of treatment verbalized by the child
  B) Nausea related to side effects of chemotherapy verbalized by the child
  C) Constipation related to the use of opioid analgesics for pain
  D) Risk for infection related to neutropenia and immunosuppression

[chjcharjto14]

Answer to Question 1

B
Feedback:
The priority would be educating the child and family about the testing procedures so they know what to expect and understand why the tests are being performed. Applying EMLA to the lumbar puncture site will be done prior to the procedure. The family will be educated about chemotherapy and its side effects prior to the therapy beginning, and promethazine or other antiemetics will be administered once chemotherapy has begun.

Answer to Question 2

D
Feedback:
The priority nursing diagnosis is risk for infection related to neutropenia and immunosuppression. The incomplete records for varicella zoster immunization can cause a problem since exposure to chickenpox could cause sepsis, so the nurse should contact the oncologist for approval to administer the vaccine. Certain vaccines are not administered when the child is immunosuppressed, so timing is crucial. Diagnoses for pain and nausea are valid for this child because he is undergoing chemotherapy, but they are not a priority. Likewise, the need for constipation management would not be necessary unless opioid use begins.