The nurse recognizes that which clients in a medical–surgical unit are at increased risk for acquiring systemic fungal infections and may require prophylactic pharmacological therapy?
Standard Text: Select all that apply.
1. The client with lupus being treated with steroids
2. The client who has AIDS
3. The client who is being treated with chemotherapy for breast cancer
4. The client who is status post a heart transplant
5. The client recovering from an appendectomy
Correct Answer: 1,2,3,4
Rationale 1: Prophylactic antifungal therapy is sometimes indicated for high-risk clients, such as those receiving prolonged therapy with corticosteroids.
Rationale 2: Prophylactic antifungal therapy is sometimes indicated for high-risk clients, such as those with HIV or AIDS.
Rationale 3: Prophylactic antifungal therapy is sometimes indicated for high-risk clients, such as those being treated with antineoplastic medications.
Rationale 4: Prophylactic antifungal therapy is sometimes indicated for high-risk clients, such as those who received an organ transplantation.
Rationale 5: A client who is status post an appendectomy is not at increased risk for developing a systemic fungal infection and would not be a candidate for prophylactic antifungal therapy.
Global Rationale: The past few decades have seen a dramatic rise in the incidence of fungal infections due to AIDS, aggressive cancer chemotherapy, the widespread use of indwelling intravenous (IV) catheters, and the use of broad-spectrum antibiotics. Corticosteroids and immunosuppressive medications associated with transplant surgery also predispose the patient to fungal infections. Appendectomy is unlikely to increase risk.
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A surgically created opening into the trachea is:
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