When in doubt, the correct answer may be the low urine output (Urine output less than 30
mL/hr)
Strong indication of a hematologic disorder = Absence of hair on the legs
ï‚· Rationale: Thinning or absence of hair on the extremities indicates poor arterial
circulation to that area
Brachytherapy Treatment
ï‚· Procedure that involves placing radioactive material inside of the body
ï‚· Indication
o Commonly used to treat prostate cancer
o Cervical cancer
o Uterine (endometrial) cancer
o Brest cancer, lung cancer, eye cancer, and skin cancer
ï‚· Nursing Considerationï€
o Nurse needs to educate the client on the importance of remaining on bed rest
with limited movement while the radioactive implant is in place to prevent
dislodgment
o Nurse should wear a lead apron when providing direct care to provide
protection from radiation source and not turn their back toward the client
o Limit each of the client’s visitors to 30 minutes per day
o Instruct visitors to remain at least 6 feet from client receiving radiation at all
times
Indication of Pancreatitis
ï‚· Increased serum lipase level
o Rationale: due to the release of lipase into the pancreas and autodigestion
ï‚· Increased WBC count (because of the inflammatory process)
ï‚· Decreased albumin level (due to the inflammatory process)
ï‚· Increase in blood glucose levels (due to a drop-in insulin production)
Polycythemia Vera
ï‚· type of blood cancer that causes bone marrow to make too many red blood cells.
ï‚· Nursing Interventions
o Patient should elevate their legs when sitting
ï‚§ Rationale: to avoid venous pooling with subsequent clot formation
o Patient should drink at least 3 Liters of fluid per day to help lower blood viscosity
o Patient should wear support hose/TED hose/SCD when awake
o Patient should use a soft toothbrush to clean their teeth (avoid flossing or
anything that increasing the risk for bleeding)