Author Question: After several doses of chemotherapy, a client complains of fatigue, pallor, progressive weakness, ... (Read 64 times)

aabwk4 · **on:** Jul 22, 2018

After several doses of chemotherapy, a client complains of fatigue, pallor, progressive weakness, exertional dyspnea, headache, and tachycardia. Which NANDA nursing diagnosis would the nurse list as the first priority?

1. Imbalanced Nutrition, Less than Body Requirements
2. Activity Intolerance
3. Powerlessness
4. Ineffective Coping

Question 2

A client has superficial burns on the hand from boiling water. Which of the following can the nurse suggest that the client use to help with the healing of these burns?

1. Evening primrose oil
2. Aloe vera gel
3. Chamomile
4. Vitamin C

randomguy133 · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

2. Activity Intolerance

Rationale:
The symptoms (fatigue, pallor, progressive weakness, exertional dyspnea, headache, and tachycardia) are caused by aplastic anemia from bone marrow suppression, which is a side effect of the chemotherapy drugs. Decreased red blood cells cause less oxygen to be delivered to body tissues, resulting in tissue hypoxia. Tachycardia is a compensation mechanism to speed up the delivery of oxygen that is available in the fewer number of cells that are present. Tissue hypoxia will result in muscle fatigue, and the symptoms that are related to aplastic anemia will decrease endurance and ability to perform activities. Thus, this NANDA diagnosis should be the first priority. Nutrition or iron deficiency is not the cause of the symptoms, which are related to tissue hypoxia. Powerlessness is the lack of control over current situations, but this is not the client's current problem. Her needs/symptoms are physical, and according to Maslow's theory must be met prior to emotional needs. Although the client might be having coping issues, the physical symptoms are her greatest complaints; therefore, coping is not the top priority in planning her care. Again, physiological needs must be met prior to self-actualization needs.

Answer to Question 2

2. Aloe vera gel

Rationale:
The nurse should provide information on home remedies that could help in the healing of the client's burns. Aloe vera gel is useful to treat superficial burns. Evening primrose oil is helpful with atopic eczema. Chamomile is helpful with skin inflammation. Vitamin C is not recommended to help with healing of the burns.