A nurse works on a pediatric oncology unit. After receiving ...

[magmichele12]

A nurse works on a pediatric oncology unit. After receiving report, which child should the nurse assess first?
 
  A.
  Having infusion of D5 NS and sodium bicarbonate
  B.
  On high-dose methotrexate (Rheumatrex), urine pH of 7.8
  C.
  Receiving cyclophosphamide (Cytoxan), urine specific gravity of 1.008
  D.
  2 days post-tumor resection, complaining of pain

Question 2

A nurse is preparing to administer chemotherapy to a child who has an Infuse-a-Port. Which action by the nurse is the most appropriate?
 
  A.
  Flush the catheter with normal saline and heparin.
  B.
  Obtain a Huber needle prior to administration.
  C.
  Unclamp the catheter prior to flushing the line.
  D.
  Wrap the catheter in gauze so it doesn't pull out.

[owenfalvey]

Answer to Question 1

ANS: B
Patients on high-dose methotrexate need their urine pH to be higher than 7.0. This child needs the nurse's attention first. An IV with NaHCO3 is common prior to receiving methotrexate. A urine specific gravity of  1.010 is required for children on chemotherapy. Pain would be an expected finding 2 days postoperatively, and should be treated, but not before the nurse assesses the other child.

Answer to Question 2

ANS: B
A centrally implanted port, such as an Infuse-a-Port, must be accessed with a Huber needle. Prior to administering medication is not the time to flush with heparin. The port is entirely indwelling, so there is no catheter to unclamp, nor will the device pull out.

[magmichele12]

Excellent

[amandalm]

TYSM