Author Question: A patient with cancer who is receiving chemotherapy develops a fever. The patient's chest radiograph ... (Read 21 times)

bobthebuilder · **on:** Jul 23, 2018

A patient with cancer who is receiving chemotherapy develops a fever. The patient's chest radiograph is normal. The patient's neutrophil count is 750/mm3. The nurse expects the provider to:

a. begin empiric therapy with intravenous antibiotics.
b. obtain cultures and wait for results before prescribing antibiotics.
c. order colony-stimulating factor to minimize neutrophilia.
d. reassure the patient that serious infection is unlikely.

Question 2

A nurse is teaching a group of nursing students about cancer treatment. Which statement by the student indicates an understanding of the characteristics of cancer cells?

a. Cancer cells are characterized by unrestrained growth and division.
b. Division of cancer cells is characteristically rapid.
c. Malignant cells of solid tumors do not invade other tissues.
d. Telomerase is an enzyme produced by cancer cells that promotes metastases.

huda · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: A
In the absence of neutrophils, as occurs with bone marrow suppression in chemotherapy, fever is the principle sign of infection. Pus, abscesses, and infiltrates on a chest x-ray may all be absent. When a neutropenic patient develops an infection, immediate and vigorous intervention is required. Empiric IV antibiotic therapy should begin while waiting for laboratory results and cultures. It is not correct to wait for culture results before initiating antibiotic therapy. Colony-stimulating factor can minimize neutropenia but does not eliminate the need for IV antibiotics. It is not correct to reassure the patient that a serious infection is unlikely.

Answer to Question 2

ANS: A
Because malignant cells are unresponsive to the feedback mechanisms that regulate cellular proliferation in healthy tissue, they are characterized by unrestrained growth and division. Division of tumor cells is not necessarily rapid. Malignant cells of all types can metastasize. Telomerase is an enzyme that permits repeated division of cancer cells.