A 30-year-old man with acute myelogenous leukemia develops an ...

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A 30-year-old man with acute myelogenous leukemia develops an absolute neutrophil count of 850/L while receiving outpatient chemotherapy. Which action by the outpatient clinic nurse is most appropriate?
 
  a. Discuss the need for hospital admission to treat the neutropenia.
  b. Teach the patient to administer filgrastim (Neupogen) injections.
  c. Plan to discontinue the chemotherapy until the neutropenia resolves.
  d. Order a high-efficiency particulate air (HEPA) filter for the patient's home.

Question 2

An appropriate nursing intervention for a patient with non-Hodgkin's lymphoma whose platelet count drops to 18,000/L during chemotherapy is to
 
  a. check all stools for occult blood.
  b. encourage fluids to 3000 mL/day.
  c. provide oral hygiene every 2 hours.
  d. check the temperature every 4 hours.

[JCABRERA33]

Answer to Question 1

ANS: B
The patient may be taught to self-administer filgrastim injections. Although chemotherapy may be stopped with severe neutropenia (neutrophil count less than 500/L), administration of filgrastim usually allows the chemotherapy to continue. Patients with neutropenia are at higher risk for infection when exposed to other patients in the hospital. HEPA filters are expensive and are used in the hospital, where the number of pathogens is much higher than in the patient's home environment.

Answer to Question 2

ANS: A
Because the patient is at risk for spontaneous bleeding, the nurse should check stools for occult blood. A low platelet count does not require an increased fluid intake. Oral hygiene is important, but it is not necessary to provide oral care every 2 hours. The low platelet count does not increase risk for infection, so frequent temperature monitoring is not indicated.

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Thank you

[JCABRERA33]

No problemo