The nurse knows the rationale for combination chemotherapy is to:
limit episodes of anticipatory and delayed emesis
lessen the client's risk of developing neutropenia
decrease time intervals between remission
broaden range of cell kill while minimizing toxicities to the client
The Correct Answer is D
A. While limiting emesis is important in cancer treatment, combination chemotherapy primarily focuses on improving efficacy and minimizing toxicities, not specifically targeting nausea and vomiting episodes.
B. Combination chemotherapy can actually increase the risk of neutropenia due to the cumulative effects of multiple agents, as each may independently lower white blood cell counts.
C. Decreasing time intervals between remission is not a primary goal of combination chemotherapy; rather, it aims to achieve better overall treatment outcomes.
D. The main rationale for using combination chemotherapy is to broaden the range of cancer cell kill through different mechanisms of action while minimizing the side effects associated with higher doses of a single agent. This approach can improve treatment efficacy and reduce the likelihood of resistance.
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Correct Answer is A
Explanation
A. Requesting a prescription to culture the wound is the priority action because the presence of redness, warmth, and serosanguinous drainage could indicate an infection that needs to be confirmed and treated appropriately.
B. While antibiotics may be necessary if an infection is confirmed, it is crucial to first determine the presence of infection through culturing the wound.
C. Assuring the client that these findings are normal may delay necessary intervention if an infection is present, which could worsen the client's condition.
D. Cleaning the wound with sterile normal saline may be appropriate as part of wound care, but it does not address the underlying concern of possible infection and would not be prioritized over obtaining a culture.
Correct Answer is C
Explanation
A. The absence of bowel sounds shortly after surgery is a common finding and does not necessarily indicate a complication at this time; it is expected during the initial postoperative period.
B. An SPO2 of 90% while the client is asleep is concerning, but it does not take precedence over signs of possible surgical complications that could require immediate intervention.
C. Increasing abdominal distention is a critical sign that could indicate serious complications such as an anastomotic leak, bowel obstruction, or intra-abdominal bleeding, and it requires immediate notification of the surgeon for further evaluation and potential intervention.
D. A small amount of green-tinged fluid from the nasogastric tube is typical postoperatively and does not necessitate immediate notification to the surgeon unless the volume is excessive or other concerning signs are present.