Scenario: A 48-year-old woman had a lumpectomy after being diagnosed with carcinoma in the left breast. She had her first chemotherapy treatment with cyclophosphamide 2 months ago. Today she is in the outpatient cancer treatment center for her sixth round of chemotherapy; radiation therapy is planned after the tenth chemotherapy treatment is completed. The nurse documents these findings as part of today’s admission assessment: Reports “feeling tired often.” “I have had diarrhea five or six times a day.” “I don’t have much of an appetite.” “I have noticed some blood in my urine, starting yesterday.” “My food doesn’t have any taste to it at all.” The patient has alopecia. Oral mucosa is inflamed with some ulcerations noted in the cheek areas. Vital signs: Temperature 100.5°F (38.1°C), Pulse 88, Respirations 12, blood pressure 118/72   Scenario: After further assessment, the patient indicated that she was menstruating. As a precaution, the chemotherapy treatment was postponed and the patient was scheduled for a follow-up in 1 week. At the follow-up appointment, her urinalysis was negative for red blood cells and the oncologist added immunotherapy to the treatment plan. The patient received the first dose of interferon and continued with the cyclophosphamide therapy. Based on the patient’s chemotherapy and immunotherapy treatment plan, the nurse is preparing a comprehensive care plan. Which actions should be included in the patient’s plan of care to address the expected side effects and optimize the patient’s health outcomes? Select all that apply.

A patient who was involved in a motor vehicle crash has had a tracheostomy placed to allow for continued mechanical ventilation. How would the nurse interpret the following arterial blood gas results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq/L?

A patient who has acute myelogenous leukemia (AML) is considering treatment with a hematopoietic stem cell transplant (HSCT). Which approach would the nurse take?

A patient who had surgery for a perforated gastric ulcer has been receiving nasogastric suction for 3 days and now has a serum sodium level of 127 mEq/L (127 mmol/L). The nurse must develop a plan of care to safely manage the patient’s hyponatremia while minimizing risks. Which interventions would the nurse include in the plan? Select all that apply.

A patient with multiple draining wounds is admitted for hypovolemia. The nurse must develop a comprehensive plan of care to manage the patient’s fluid balance. Which interventions and assessments should the nurse include in the plan? Select all that apply.

The nurse is assessing a patient with chronic obstructive pulmonary disease (COPD) by placing their hands on the lower thorax to evaluate diaphragmatic movement during breathing. What is the nurse assessing for with this technique?

A postoperative patient following a thoracotomy reports incisional pain, has a poor cough effort, and exhibits scattered coarse crackles upon auscultation. The nurse knows these findings indicate a risk for postoperative pulmonary complications. After assessing the situation, which action should the nurse prioritize to improve the patient’s respiratory status?

A patient recently diagnosed with cervical cancer that is classified as Tis, N0, M0 appears anxious and asks the nurse what the letters and numbers mean. What is the most appropriate response by the nurse to provide both information and emotional support?

NGN Case Study Title: Cancer and Chemotherapy Questions 18-23 will address an unfolding case study. Scenario: A 48-year-old woman had a lumpectomy after being diagnosed with carcinoma in the left breast. She had her first chemotherapy treatment with cyclophosphamide 2 months ago. Today she is in the outpatient cancer treatment center for her sixth round of chemotherapy; radiation therapy is planned after the tenth chemotherapy treatment is completed. The nurse documents these findings as part of today’s admission assessment.  Place a check mark next to any of the assessment findings that require follow-up by the nurse.

Fill in each blank with the correct form of the future tense of the verb that is in parenthesis.   Concepción=a city in Chile discurso=speech emocionada=excited letras especiales:  á    é     í     ó     ú   ñ La candidata Emilia Salinas [1](salir) para Concepción mañana y allí ella [2](dar)  un discurso.  Ella  [3] (hablar) en la Plaza Central y [4](tener) que explicar sus ideas sobre la economía.  Muchas personas [5] (venir) a oír el discurso y muchos de ellos (querer)  [6]hacer preguntas después.  Veinte ciudadanos [7] (poder) cenar con la candidata y yo[8](ser)una de ellos.  Yo [9] (estar) nerviosa pero emocionada.  Yo le [10] ( hacer)una pregunta sobre la inflación.  Mi amiga Lidia [11](ir) también y sé que nosotras [12] (saber)  mucho mas sobre la candidata después de la cena.