The nurse on the transplant unit is reviewing assessment data for a group of patients. Which patients should the nurse realize are at greatest risk for graft-versus-host disease?
1. Patients A and C
2. Patient A only
3. Patient B only
4. Patient D only
Correct Answer: 3
Graft-versus-host disease (GVHD) is a potentially fatal complication of stem cell transplantation to immunocompromised patients. Acute GVHD occurs within the first 100 days following a transplant and primarily affects the skin, liver, and gastrointestinal tract. The patient develops a maculopapular pruritic rash beginning on the palms of the hands and soles of the feet. The rash may spread to involve the entire body and lead to desquamation. Gastrointestinal manifestations include abdominal pain, nausea, and bloody diarrhea. GVHD that lasts longer than 100 days is said to be chronic. If it is limited to the skin and liver, the prognosis is good. If multiple organs are involved, the prognosis is poor.
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An older client is exhibiting symptoms of major depressive disorder. A physician is considering prescribing an antidepressant. Which physiological problem should make a nurse question this medication regime?
1. Altered cortical and intellectual functioning 2. Altered respiratory and gastrointestinal functioning 3. Altered liver and kidney functioning 4. Altered endocrine and immune system functioning
Which of the following levels of government primarily establishes regulations and provides funding for health care?
a. Federal government b. Local health departments c. Regional health districts d. State health departments
During a health history the nurse suspects a patient has been experiencing stable angina. What did the patient most likely describe to the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected
Select all that apply. 1. Chest pain that lasts between 5 to 10 minutes 2. Chest pain that occurs during stress 3. Chest pain that occurs when out of doors on very cold days 4. Chest pain that stops with rest 5. Chest pain that occurs at rest
Secondary prevention in the occupational health arena may include:
a. Providing education on safety in the workplace to prevent injury b. Working with chronically diabetic workers to ensure appropriate medications c. Screening for hearing loss resulting from noise levels in the plants d. Ensuring that a person with cardiovascular disease attends a rehab program