A patient tells a nurse that she drinks wine for its ...

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A patient tells a nurse that she drinks wine for its cardioprotective effects. She wants to know how much is safe. The nurse is correct in telling her that:
 
  a. A couple of glasses of wine 1 or 2 days a week will help prevent heart disease.
  b. Abstaining from alcohol completely is the best way to prevent heart disease.
  c. If you drink only on weekends, you will minimize your risk of developing heart disease.
  d. Cardioprotective effects are greatest in people who live an unhealthy lifestyle.

Question 2

A patient with lung cancer receives filgrastim Neupogen after chemotherapy to reduce neutropenia. The patient reports a moderate degree of bone pain. What will the nurse do?
 
  a. Obtain an order to administer acetamino-phen.
  b. Request an order for a complete blood count (CBC).
  c. Request an order to reduce the dose of filgrastim.
  d. Suspect metastasis of the cancer to the bone.

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Answer to Question 1

D
Moderate consumption, which for women is 1 drink a day or less, has been shown to reduce the incidence of ischemic stroke, coronary artery disease, myocardial infarction, and heart failure. The pattern determines protection as well; moderate consumption 3 or 4 days a week rather than 1 or 2 days is more protective. These effects are greatest in people who have an unhealthy life-style, who do not eat fruits and vegetables, and who smoke. Having a couple of glasses of wine exceeds the moderate amount for women. Moderate consumption, as just described, has better protective benefits than complete abstinence. Drinking on weekends does not fit the pattern of 3 or 4 days per week that has been shown to be protective.

Answer to Question 2

A
Bone pain occurs in about 25 of patients receiving filgrastim. It can be treated with a nonopioid analgesic and, if necessary, an opioid analgesic. Leukocytosis can occur, but bone pain is not a symptom of this, so a CBC is not indicated. Bone pain is not an indication for reducing the dose of filgrastim. Because moderate bone pain is a common adverse effect, metastasis to the bone is less likely.

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