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 B
Explanation
A. While a diet of soft foods and liquid protein may be beneficial for a client undergoing chemotherapy, it is not the most critical intervention related to thrombocytopenia. Nutritional needs can be managed but do not address the immediate risk of bleeding or injury.
B. Teaching safety in the home to reduce injury and falls is the most important intervention. Clients with thrombocytopenia have a significantly increased risk of bleeding and bruising, making it essential to prevent falls and injuries that could lead to serious complications.
C. Spacing activities throughout the day can help manage fatigue, but it is not as urgent as ensuring the client is safe from injuries related to low platelet counts.
D. Frequent hand hygiene is important to prevent infections, especially in immunocompromised patients, but it does not directly address the primary concern of preventing injuries related to thrombocytopenia.
Correct Answer is C
Explanation
A. The absence of bowel sounds shortly after surgery is not uncommon, especially within the first few hours, and does not necessarily indicate a complication at this time.
B. An SPO2 of 90% while the client is asleep may warrant attention, but it is not as critical as signs of a potential surgical complication. The nurse should assess the patient's respiratory status and consider interventions, but immediate notification to the surgeon is not required.
C. Increasing abdominal distention is a concerning sign that may indicate complications such as an anastomotic leak or bowel obstruction, which requires immediate evaluation and possible intervention by the surgeon.
D. A small amount of green-tinged fluid from the nasogastric tube is generally expected postoperatively and does not necessarily indicate a problem, thus does not require immediate notification of the surgeon.