You are caring for a client with multiple myeloma. Why would it be important to assess this client for fractures?
A) Osteopathic tumors destroy bone causing fractures.
B) Osteoclasts break down bone cells so pathologic fractures occur.
C) Osteolytic activating factor weakens bones producing fractures.
D) Osteosarcomas form producing pathologic fractures.
B
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The abnormal plasma cells proliferate in the bone marrow, where they release osteoclast-activating factor. This, in turn, causes osteoclasts to break down bone cells, resulting in increased blood calcium and pathologic fractures. The plasma cells also form single or multiple osteolytic (bone-destroying) tumors that produce a "punched-out" or "honeycombed" appearance in bones such as the spine, ribs, skull, pelvis, femurs, clavicles, and scapulae. Weakened vertebrae lead to compression of the spine accompanied by significant pain. Options A, C, and D are distractors for this question.
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A. Manipulate the catheter to move it away from the blood vessel wall. B. Discontinue the medication and flush the line with heparin. C. Document the findings as the only action. D. Notify the emergency team.
Historical roots of caring for self are theoretically rooted in nursing practice. Nurse theorists who advocate for this perspective according to this chapter include:
a. Delores Krieger and Martha Rogers. b. Sister Callista Roy and Imogene King. c. Virginia Henderson and Sierra Leone. d. Marlene Kramer and Dorothy Brooten.