The nurse is caring for a patient with stage IV Hodgkin disease. Where should the nurse expect to find enlarged lymph nodes during the assessment?
Two areas of lymph nodes above and below the diaphragm
Two or more areas on the same side of the diaphragm
Localized in the cervical neck area only
Generalized throughout the body within multiple organs
The Correct Answer is D
A. Two areas of lymph nodes above and below the diaphragm: This describes stage III Hodgkin disease, where lymph node involvement occurs both above and below the diaphragm, but not necessarily in multiple organs.
B. Two or more areas on the same side of the diaphragm: This corresponds to stage II Hodgkin disease, which is limited to two or more lymph node regions on the same side of the diaphragm.
C. Localized in the cervical neck area only: Stage I Hodgkin disease typically involves a single lymph node region, often the cervical nodes, without generalized or extensive spread.
D. Generalized throughout the body within multiple organs: In stage IV Hodgkin disease, the cancer has spread beyond the lymph nodes to other organs and tissues, leading to generalized lymphadenopathy and potential organ involvement.
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Correct Answer is D
Explanation
A. Heat relaxes the muscles and distracts the patient from the pain. While warmth can provide comfort, the main goal is to improve circulation rather than distraction.
B. Sickle cell crisis pain can be exacerbated with shivering. Although shivering may be uncomfortable, it is not the primary reason for using heat during a sickle cell crisis.
C. Heat promotes proper formation of red blood cells (RBCs) and prevents sickling. Heat does not affect RBC formation or prevent sickling. The condition of sickling is due to genetic factors, not temperature.
D. Heat increases circulation by preventing vasoconstriction. In sickle cell crisis, warmth helps prevent vasoconstriction, which can reduce blood flow to areas already compromised by sickled cells. Preventing vasoconstriction may help alleviate pain and improve circulation.
Correct Answer is C
Explanation
A. Cryoprecipitates: Cryoprecipitates contain fibrinogen, factor VIII, von Willebrand factor, and factor XIII, and are typically used for patients with specific factor deficiencies, such as hemophilia or fibrinogen deficiency, rather than general clotting disorders.
B. Frozen Packed Red Blood Cells (PRBCs): PRBCs are primarily used to treat anemia and to increase oxygen-carrying capacity, not to correct clotting factor deficiencies.
C. Fresh frozen plasma (FFP): Fresh frozen plasma (FFP) contains clotting factors and is administered to patients with clotting disorders to help manage bleeding by replenishing these factors.
D. Platelets: Platelets are administered to patients with thrombocytopenia or platelet dysfunction, not to replace clotting factors as needed in general clotting disorders.