Because H.J.'s condition has stabilized, the oncologist orders another round of chemotherapy
Because the TLS is just resolving, what interventions would you include in your plan
of care?
What will be an ideal response?
• Maintain a fluid intake, through IV and oral fluids, of at least 5000 mL on the day of and for 3 days
after treatment. Keep the fluid intake consistent throughout the 24-hour day.
• To assist with oral intake, administer the antiemetic regimen appropriate to his chemotherapy
regimen.
• Continue to administer the allopurinol (Aloprim) to decrease uric acid concentration. Sodium
bicarbonate can be added to some IV fluids to promote fecal excretion of excess phosphate and to
help prevent uric acid precipitation.
• Assessment and continued monitoring are important. You will need to monitor for critical
laboratory changes or development of symptoms and notify the physician immediately if there are
indications that TLS is recurring.
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To prevent ________________ ________________, the nurse warms the blood that is to be given as a transfusion through a central line
ANS:
Which situation(s) reflect legal issues associated with telenursing? Select all that are correct
1. The nurse who is licensed in one state is caring for a patient who is in a different state. 2. The use of telenursing equipment is new in the hospital and requires the presence of a non-medical technician. 3. Standards of care in one state's hospitals are different from those in hospitals in another state. 4. The nurse in one state holds an associate degree in nursing and the nurse in the other state holds a baccalaureate degree in nursing. 5. The nurse using telemedicine is paid by the patient "visit," while the hospital staff nurse is paid by the shift.
Which client is at greatest risk for the development of hyperkalemia?
A. 60-year-old man with heart failure using a salt substitute B. 60-year-old woman taking a thiazide diuretic for hypertension C. 40-year-old woman taking NSAIDs daily for rheumatoid arthritis D. 40-year-old man with type 2 diabetes taking an oral antidiabetic agent
The nursing staff is informed that the current system of record keeping is going to be changed to make it more efficient. In which stage of change is the nursing staff?
1. Refreezing 2. Unfreezing 3. Moving 4. Drift