The client with neutropenia should not have fresh fruit because it should be peeled and/or cooked before eating. He should also not eat foods grown on or in the ground or eat from the salad bar. The nurse should remove potted or cut flowers from the room as well. Any source of bacteria should be eliminated, if possible.

Option A: Educate clients and SO about appropriate methods for cleaning, disinfecting, and sterilizing items. Knowledge of ways to reduce or eliminate germs reduces the likelihood of transmission.
Option B: Perform measures to break the chain of infection and prevent infection. Assist clients in carrying out appropriate skin and oral hygiene. Instruct clients to perform hand hygiene when handling food or eating.
Option C: Place the patient in protective isolation if the patient is at high risk of infection. Protective isolation is set when the WBC indicates neutropenia. Wear personal protective equipment (PPE) properly.

Dextrose in normal saline is indicated as a source of water, electrolytes, and calories. Early complications after total laryngectomy are bleeding, postoperative edema, and airway compromise, these, especially in the immediate postoperative, should be carefully monitored.

Option A: In clients who have not had surgery to the face or neck, however, in this situation, this could further interfere with the airway. Increasing the infusion and placing the client in supine position would be better.
Option C: Administration of atropine IV is not necessary at this time and could cause hyponatremia and further hypotension. Administration of corticosteroids is recommended to minimize postoperative edema and airway compromise, hematoma or seroma, that should be prompt surgically evacuated, wound infection related to the perioperative exposure of the wound to bacteria, it could be minimized using a broad-spectrum antibiotic coverage and pharyngocutaneous fistula; total laryngectomy patients are at risk for pharyngeal suture line dehiscence with a resultant pharyngocutaneous fistula.
Option D: Moving the emergency cart at the bedside is not necessary at this time. The primary goal for the treatment of laryngeal cancer is the control of the disease. Preservation of speech, swallowing functions, and avoidance of the tracheostomy are secondary goals. Traditionally the treatment of laryngeal carcinomas has been radiotherapy or surgery or a combination of both.

If the client pulls the chest tube out of the chest, the nurse’s first action should be to cover the insertion site with an occlusive dressing. Afterward, the nurse should call the doctor, who will order a chest x-ray and possibly reinsert the tube. A chest tube may be inserted at the bedside, in the procedure room, or in the surgical suite. Health care providers often assist physicians in the insertion and removal of a closed chest tube drainage system.

Option A: A chest tube falling out is an emergency. Immediately apply pressure to the chest tube insertion site and apply sterile gauze or place a sterile Jelonet gauze and dry dressing over the insertion site and ensure tight seal. Apply dressing when the patient exhales. If a patient goes into respiratory distress, call a code. Notify primary health care providers to reinsert new chest tube drainage systems.
Option B: A chest tube drainage system disconnecting from the chest tube inside the patient is an emergency. Immediately clamp the tube and place the end of the chest tube in sterile water or NS. The two ends will need to be swabbed with alcohol and reconnected.
Option D: After initial insertion of a chest tube drainage system, assess the patient every 15 minutes to 1 hour. Once the patient is stable, and depending on the condition of the patient and the amount of drainage, monitoring may be less frequent. If the patient is stable (vital signs within normal limits; drainage amount, colour, or consistency is within normal limits; the patient is not experiencing any respiratory distress or pain), assessment may be completed every 4 hours. Always follow hospital policy for frequency of monitoring a patient with a chest tube.

The normal Protime is 12–20 seconds. A Protime of 120 seconds indicates an extremely prolonged Protime and can result in a spontaneous bleeding episode. Patients receiving treatment with warfarin should have close monitoring to ensure the safety and efficacy of the medication. Periodic blood testing is the recommendation to assess the patient’s prothrombin time (PT) and the international normalized ratio (INR).

Option B: The laboratory parameter utilized to monitor warfarin therapy is the PT/INR. The PT is the number of seconds it takes the blood to clot, and the INR allows for the standardization of the PT measurement depending on the thromboplastin reagent used by a laboratory. Therefore, monitoring a patient’s INR while on warfarin is strongly preferable over PT because it allows for a standardized measurement without variations due to different laboratory sites.
Option C: When managing warfarin toxicity, the initial step would be to discontinue warfarin and then administer vitamin K (phytonadione). The vitamin K may administration can be either via the oral, intravenous, or subcutaneous route. However, the initial administration of oral vitamin K is often preferable in patients without major bleeding or extremely elevated INR.
Option D: Patients also require close monitoring for signs and symptoms of active bleeding throughout their treatment. Close monitoring for signs and symptoms of bleeding, such as dark tarry stools, nosebleeds, and hematomas, is necessary. The patient’s hemoglobin and hematocrit level should undergo an assessment before initiating warfarin and approximately every six months while on therapy.

The food with the most calcium is the yogurt, which has approximately 400 mg of calcium. A growing baby needs a considerable amount of calcium to develop. If the mother does not consume enough calcium to sustain the needs of the developing baby, the body will take calcium from the bones, decreasing bone mass and putting the mother at risk for osteoporosis. Osteoporosis causes dramatic thinning of the bone, resulting in weak, brittle bones that can easily be broken.

Option A: Eat a variety of foods to get all the nutrients you need. Recommended daily servings include 6-11 servings of breads and grains, two to four servings of fruit, four or more servings of vegetables, four servings of dairy products, and three servings of protein sources (meat, poultry, fish, eggs or nuts).Consume fats and sweets sparingly.
Option B: Choose foods high in fiber that are enriched, such as whole-grain breads, cereals, beans, pasta and rice, as well as fruits and vegetables. Although it’s best to get fiber from foods, taking a fiber supplement can help get the necessary amount.
Option D: A glass of fruit juice is mainly rich in vitamin C and fiber. Choose at least one good source of vitamin C every day, such as oranges, grapefruits, strawberries, honeydew, papaya, broccoli, cauliflower, Brussels sprouts, green peppers, tomatoes, and mustard greens. Pregnant women need 80 – 85 mg of vitamin C a day.