When caring for a client who just had a stem-cell transplant, the most important parameter to monitor is temperature, because these patients experience complete bone marrow suppression with chemotherapy, leaving them with no immune system and making any infection life-threatening; this takes priority over monitoring pain level, serum electrolyte levels, or hemoglobin and hematocrit, which are important but less urgent concerns.
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NCLEX question breakdown with Dr. Emily | Stem Cell Transplant | NCLEX BootcampHinzugefügt:
If you're caring for a client who just had a stem-cell transplant, would it be most important to monitor the client's pain level, temperature, serum electrolyte levels, or hemoglobin and hematocrit? So, remember, when you're asked what's most important, you should keep BootCamp's prioritization pyramid in mind, which prioritizes airway and safety, followed by problems of breathing, circulation, and disability.
So, let's take a look. For their pain level, this is always important to monitor, but unless it's a specific kind of life-threatening pain, like a ruptured ectopic pregnancy, it's usually not the priority. So, let's hold off on that one. Is it important to monitor their temperature? Yes. Remember, clients who get a stem-cell transplant first have complete bone marrow suppression with chemotherapy. So, they have no immune system, and any infection can be life-threatening. So, this is probably our right answer, but let's check our last two. For serum electrolyte levels, again, this is important for every patient, and it can help tell us if they're developing tumor lysis syndrome, but that's not as important as a life-threatening infection. And finally, hemoglobin and hematocrit. So, that is important, and it's going to tell us that they're becoming anemic from that bone marrow suppression, but this usually happens gradually, and that's easily corrected with a blood transfusion or erythropoietin, whereas a fever in an immunosuppressed client is considered a life-threatening emergency. So, that is our priority. Comment to let us know if you got it right.
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