An immunocompromised patient is being treated in the hospital. The nurse's assessment reveals that the patient's submandibular lymph nodes are swollen, a finding that represents a change from the previous day. What is the nurse's most appropriate action?
A) Administer a PRN dose of acetaminophen as ordered.
B) Monitor the patient's vital signs q2h for the next 24 hours.
C) Inform the patient's primary care provider of this finding.
D) Implement standard precautions in the patient's care.
Ans: C
Feedback:
Swollen lymph nodes are suggestive of infection and warrant prompt medical assessment and treatment. Acetaminophen is an ineffective response. The nurse should monitor the patient's vital signs closely, but the physician should also be informed. Standard precautions should be in place regardless of the patient's status.
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