The nurse is preparing a patient for plasmapheresis. In which ...

[torybrooks]

The nurse is preparing a patient for plasmapheresis. In which order should the nurse complete the following actions?
 
  Choice 1. Check with physician about holding medications.
  Choice 2. Assess vital signs and weight.
  Choice 3. Verify blood type and crossmatch for replacement blood products.
  Choice 4. Assess for dizziness or hypotension.
  Choice 5. Assess intravenous port for bruising.
  Choice 6. Reevaluate laboratory data, especially CBC, platelet count, and clotting times.

Question 2

The nurse is completing discharge teaching to a patient with a new diagnosis of multiple sclerosis (MS). What does the nurse recommend about diet?
 
  1. Focus on maintaining a weight as close as possible to what is recommended for the patient's height and weight.
  2. Increase fats and lower carbohydrates.
  3. Include foods that are easy to swallow since dysphagia is a problem seen in the early stages of the disease.
  4. Basically remain the same, as there are no nutritional changes in the MS patient.

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Answer to Question 1

Correct Answer: 1, 2, 3, 4, 5, 6
Check with the physician about holding medications until after the procedure. Medications may be removed from the body as an incidental part of the plasmapheresis process. Assess vital signs and weight. Baseline parameters are necessary to evaluate for fluid imbalances and response to therapy. Check blood type and crossmatch for replacement blood products. Hypersensitivity reactions can occur, and close monitoring is important. During the procedure, assess for dizziness or hypotension due to hypovolemia, which can occur. Hypovolemia is a complication of plasma exchange, especially during the procedure when up to 15 of the patient's blood volume is in the cell separator. After the procedure, assess the intravenous port for signs of bruising. The site of vascular access is at risk for complications and must be routinely and carefully assessed for bleeding or hematoma formation. Reevaluate laboratory data since anticoagulation is part of the procedure. The cell-separating process can damage cells; anticoagulation is part of the procedure.

Answer to Question 2

Correct Answer: 1
It is recommended that the MS patient should ideally maintain a weight as close as possible to what is recommended for the patient's height and weight. There is no reason for the patient to increase fat intake and decrease carbohydrates. Dysphagia is seen in the later stages of the disease. Dysphagia is a common problem as MS progresses. At that point, the diet should be adapted to accommodate changes in the patient's ability to chew and swallow, and collaboration with a dietitian will be important.

[torybrooks]

Excellent

[frankwu0507]

TYSM