The nurse reviews the laboratory results of a patient who is ...

[amal]

The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which laboratory result is most important to report to the health care provider?
 
  a. Hematocrit of 30
  b. Platelets of 95,000/L
  c. Hemoglobin of 10 g/L
  d. White blood cell (WBC) count of 2700/L

Question 2

The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in therapy with the health care provider?
 
  a. Poor oral intake
  b. Frequent loose stools
  c. Complaints of nausea and vomiting
  d. Increase in carcinoembryonic antigen (CEA)

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Answer to Question 1

ANS: D
The low WBC count places the patient at risk for severe infection and is an indication that the chemotherapy dose may need to be lower or that WBC growth factors such as filgrastim (Neupogen) are needed. Although the other laboratory data indicate decreased levels, they do not indicate any immediate life-threatening adverse effects of the chemotherapy.

Answer to Question 2

ANS: D
An increase in CEA indicates that the chemotherapy is not effective for the patient's cancer and may need to be modified. The other patient findings are common adverse effects of chemotherapy. The nurse may need to address these, but they would not necessarily indicate a need for a change in therapy.

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