The nurse in the oncology clinic is caring for a 55-year-old female client
Item 1 of 1
- Nurses' Notes
1300 – Client is here for a prescribed chemotherapy infusion (four of eight infusions). Client receiving treatment for stage IV breast cancer with metastasis to the liver. Client reports significant fatigue, which has caused her to nap more and procrastinate on her activities of daily living. She reports that no matter how much she sleeps, she never feels rested. The client stated that her hands and feet feel like 'pins and needles' and have worsened since the previous treatment. She reports using topical ointments and creams with no relief. Finally, the client reports experiencing night sweats that started last night and feeling 'hot' today. On assessment, the client is alert and completely oriented. Lung sounds are clear bilaterally, and respirations are unlabored. Skin hot and pale pink in tone; peripheral pulses 2+ and regular. Capillary refill is 3 seconds. Vital signs: T 101.1° F (38.4° C), P 92, RR 18, BP 133/76, pulse oximetry reading 95% on room air.
Complete the following sentence by choosing from the list of options
Complete the following sentence by choosing from the list of options
The nurse is highly concerned about the client's risk for
based on the client's
Statistics
Subject/Lesson
Subject
Adult Health
Lesson
Hematological/Oncological
Client Need
Test Plan
Physiological Adaptation
Related Topic
Alterations in Body Systems
Item Type
Item Type
AnalyzeCues
Explanation
- The client is receiving chemotherapy which likely causes immunosuppression. The client's manifestations of infection (night sweats, fever) warrant follow-up because, without treatment, the client may risk sepsis. The nurse must act on these manifestations by informing the physician.
- The client's neuropathic pain is an unfortunate effect of most chemotherapy medications. This does require follow-up but would not be life-threatening compared to a systemic infection.
- Fatigue is a common effect of chemotherapy. Instructing the client to regulate their sleep-wake cycle, optimize their nutrition, and take frequent rest breaks would be reasonable education to provide. Fatigue would not prioritize infection, which could be life-threatening.
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4 Key Topics
Transmission based precautions- Immune System
23.3 Infection Control & Infectious Diseases
Chemotherapy
33.2 General Cancer Signs & Treatment Precautions
Additional Info
✓ Chemotherapy may cause an array of effects, including pancytopenia (low red blood cells; low platelets; low white blood cells)
✓ The nurse is responsible for monitoring the client's laboratory data and relaying manifestations of infection to the physician
✓ The nurse should educate and reinforce to the client risk reduction strategies for infection, such as the need for meticulous hand hygiene, wearing a surgical mask in public places, and maintaining good oral hygiene
✓ Neuropathic pain may consequently develop from medications such as doxorubicin which may be mitigated with prescribed gabapentin or pregabalin
