Nokea
The nurse is caring for a child receiving chemotherapy for leukemia. The childs granulocyte count is 600/mm3 and platelet count is 45,000/mm3. What oral care should the nurse recommend for this child?
- A. Rinsing mouth with water
- B. Daily toothbrushing and flossing
- C. Lemon glycerin swabs for cleansing
- D. Wiping teeth with moistened gauze or Toothettes
Correct Answer: B
Rationale: With granulocytes above 500/mm3 and platelets above 40,000/mm3, daily toothbrushing and flossing are safe and effective for oral hygiene. Water rinsing is inadequate, lemon glycerin swabs irritate and dry mucosa, and gauze/Toothettes are for lower counts.
You may also like to solve these questions
After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention?
- A. Hydration
- B. Oxygenation
- C. Corticosteroids
- D. Pain management
Correct Answer: A
Rationale: Hydration prevents acute tumor lysis syndrome by reducing metabolic complications (e.g., hyperuricemia, hyperkalemia) from cell breakdown during leukemia treatment. Oxygenation, corticosteroids, and pain management don?t address this syndrome directly.
Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention?
- A. Restrict oral fluids.
- B. Institute strict isolation.
- C. Use good hand-washing technique.
- D. Give immunizations appropriate for age.
Correct Answer: C
Rationale: Good hand-washing reduces infection risk in myelosuppressed children by minimizing exposure to pathogens. Oral fluids are encouraged, strict isolation isn?t needed, and immunizations are ineffective or risky during immunosuppression.
What type of chemotherapeutic agent alters the function of cells by replacing a hydrogen atom of a molecule?
- A. Plant alkaloids
- B. Antimetabolites
- C. Alkylating agents
- D. Antitumor antibiotics
Correct Answer: C
Rationale: Alkylating agents replace a hydrogen atom with an alkyl group, disrupting DNA and causing cell death. Plant alkaloids block spindle formation, antimetabolites mimic metabolic elements to halt DNA synthesis, and antitumor antibiotics interfere with DNA replication and transcription.
In teaching parents how to minimize or prevent bleeding episodes when the child is myelosuppressed, the nurse includes what information?
- A. Meticulous mouth care is essential to avoid mucositis.
- B. Rectal temperatures are necessary to monitor for infection.
- C. Intramuscular injections are preferred to intravenous ones.
- D. Platelet transfusions are given to maintain a count greater than 50,000/mm3.
Correct Answer: A
Rationale: Meticulous mouth care prevents gingival bleeding and mucositis in myelosuppressed children with low platelets. Rectal temperatures and intramuscular injections risk bleeding and infection, and platelet transfusions are typically given below 10,000/mm3 or with active bleeding.
What chemotherapeutic agent is classified as an antitumor antibiotic?
- A. Cisplatin (Platinol AQ)
- B. Vincristine (Oncovin)
- C. Methotrexate (Texall)
- D. Daunorubicin (Cerubidine)
Correct Answer: D
Rationale: Daunorubicin is an antitumor antibiotic that disrupts DNA replication. Cisplatin is an alkylating agent, vincristine is a plant alkaloid, and methotrexate is an antimetabolite, each with distinct mechanisms of action.