Hematological and Immune Disorders Questions with Rationale

Hematological and Immune Disorders The nurse should instruct the client to notify the physician if which adverse drug reaction occurs? 1. Dysuria 2. Tinnitus 3. Leg cramps 4. Constipation Answer 2: RATIONALES: The client with rheumatoid arthritis typically takes a relatively high dosage of aspirin for its anti-inflammatory effect. The nurse should instruct the client to report signs and symptoms of aspirin toxicity, such as tinnitus (ringing in the ears). The other options aren't associated with aspirin use or toxicity. A client with acquired immunodeficiency syndrome (AIDS) is admitted with Pneumocystis carinii pneumonia. During a bath, the client begins to cry and says that most friends and relatives have stopped visiting and calling. What should the nurse do? 1. Continue with the bath and tell the client not to worry. 2. Ask the physician to obtain a psychiatric consultation. 3. Listen and show interest as the client expresses feelings. 4. State that these friends' behavior shows that they aren't true friends. Answer: 3 RATIONALES: The nurse should listen actively and nonjudgmentally as the client expresses feelings. Telling the client not to worry would provide false reassurance. A psychiatric consultation would be appropriate only after further assessment. Stating that the client's friends aren't true friends would discount the client's feelings. Which nonpharmacologic interventions should the nurse include in the care plan for a client who has moderate rheumatoid arthritis (RA)? 1. Massaging inflamed joints 2. Avoiding range-of-motion (ROM) exercises 3. Applying splints to inflamed joints 4. Using assistive devices at all times 5. Selecting clothing that has Velcro fasteners 6. Applying moist heat to joints Answer 3,5,6 RATIONALES: Supportive, nonpharmacologic measures for the client with RA include applying splints to rest inflamed joints, using Velcro fasteners on clothes to aid in dressing, and applying moist heat to joints to relax muscles and relieve pain. Inflamed joints should never be massaged because doing so can aggravate inflammation. A physical therapy program, including ROM exercises and carefully individualized therapeutic exercises, prevents loss of joint function. Assistive devices should be used only when marked loss of ROM occurs.