Effective Interventions for Chemotherapy-Induced Myelosuppression to Prevent Infection, Bleeding, and Anemia

The nurse is caring for a patient with non-Hodgkin’s lymphoma, stage IV. He received chemotherapy 10 days ago using the following drugs: doxorubicin, cyclophosphamide, vincristine, and prednisone through his vascular access device. His blood test result revealed WBC count of 1500/ml, hemoglobin of 7.6 g/dl, RBC of 3,000,000/ml, hematocrit of 22.3%, platelet count of 20,000/ml. Which of the following interventions will the nurse include in the care plan for this patient?- Telling the patient to use a soft toothbrush and avoid dental floss- Advise the patient to eat a low residue diet- Do nail care by cutting fingernails and toenails to prevent scratching that may lead to bleeding or infection- Insert two additional IV lines for blood transfusions

Based on the patient’s blood test result, it is evident that the patient is experiencing chemotherapy-induced myelosuppression, which is a decrease in the production of blood cells

Based on the patient’s blood test result, it is evident that the patient is experiencing chemotherapy-induced myelosuppression, which is a decrease in the production of blood cells. This condition can lead to increased risk of infection, bleeding, and anemia. Therefore, the nurse should include interventions in the care plan to address these issues.

1. Telling the patient to use a soft toothbrush and avoid dental floss: This intervention is related to the risk of infection. Chemotherapy can cause mucositis, an inflammation of the mucous membranes in the mouth, which can lead to oral infections. Using a soft toothbrush and avoiding dental floss can help prevent trauma to the mouth and decrease the risk of infection.

2. Advise the patient to eat a low residue diet: This intervention is related to the risk of infection and bleeding. A low residue diet consists of easily digestible foods that are less likely to cause irritation or injury to the gastrointestinal tract. This can help prevent infection and reduce the risk of bleeding in the intestines.

3. Do nail care by cutting fingernails and toenails to prevent scratching that may lead to bleeding or infection: This intervention is related to the risk of infection and bleeding. By keeping the patient’s nails short, the risk of scratching themselves and introducing bacteria into the body is reduced. It also helps prevent bleeding if the patient accidentally scratches or injures themselves.

4. Insert two additional IV lines for blood transfusions: This intervention is not necessary at this point based on the given information. While the patient’s blood counts are low, the decision to initiate blood transfusions would depend on various factors such as the patient’s symptoms, severity of anemia, and individualized treatment goals. If the patient is symptomatic (e.g., experiencing signs of anemia such as shortness of breath or fatigue) or if their platelet count drops significantly (less than 10,000/ml), blood transfusions may be considered. However, this decision should be made by the healthcare provider based on further assessment and evaluation.

In summary, the nurse should include interventions such as advising the patient to use a soft toothbrush and avoid dental floss, advising the patient to eat a low residue diet, and performing nail care by cutting fingernails and toenails to prevent scratching that may lead to bleeding or infection. At this point, inserting additional IV lines for blood transfusions is not indicated based on the information provided.

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