Question

The nurse is caring for clients on an oncology unit. The supervisor calls to report a need to place two of the patients in the same room. Which of the following patient pairs is best? A. A postoperative laminectomy done to decrease spinal cord compression and a patient with a craniotomy due to lung cancer metastasis B. A patient with neutropenia and a patient receiving a blood transfusion C. A patient with pancreatic cancer and a patient with a white blood cell count of 200 D. A patient on high dose chemotherapy and a patient with prostate cancer who is receiving radiation by external beam

Short answer

Answer: Pair C, consisting of a patient with pancreatic cancer and a patient with a white blood cell count of 200, is the best option for the oncology unit as they have similar risk levels and are less likely to endanger each other.

Step-by-step solution

Identify each patient's condition

The exercise provides four potential pairings of patients with various medical conditions related to oncology. In order to decide which pair is the best, we need first to identify each patient's condition and treatment. A. Patient 1: postoperative laminectomy for spinal cord compression, Patient 2: craniotomy due to lung cancer metastasis B. Patient 1: neutropenia, Patient 2: receiving a blood transfusion C. Patient 1: pancreatic cancer, Patient 2: white blood cell count of 200 D. Patient 1: high dose chemotherapy, Patient 2: prostate cancer who is receiving radiation by external beam

Evaluate the risks and compatibility of each pair

After identifying each patient's condition, we can now assess the potential risks and compatibility of each patient pairing: A. Patients who recently had surgery should be kept in a clean and quiet environment to minimize infection risk. A craniotomy patient might need a higher level of monitoring and care that could disturb the other patient's recovery. B. A patient with neutropenia has a low white blood cell count and a weakened immune system, putting them at higher risk for infections. Placing them with a patient receiving a blood transfusion may expose them to potential infection sources or complications. C. In this case, one patient has pancreatic cancer, and the other has a low white blood cell count of 200, suggesting an increased risk for infections. These patients may be a suitable match since both are at similar risk levels and are unlikely to pose any danger to each other. D. Patients receiving high-dose chemotherapy and radiation therapy have different treatment regimens, and placing them together may not be ideal. Additionally, the high-dose chemotherapy patient may experience more side effects and require additional care that could disturb the other patient's treatment.

Determine the best patient pair

Considering the potential risks and compatibility levels for each patient pair, the best option in this scenario is pairing C. This pair consists of a patient with pancreatic cancer and a patient with a white blood cell count of 200. Since both patients have similar risk levels and are less likely to endanger each other, this is the ideal pairing for the oncology unit.

Key concepts

Oncology Nursing

Oncology nursing is a specialized field of nursing dedicated to caring for patients who are undergoing treatment for cancer. It requires a deep understanding of the disease process, the various treatments available, and the unique needs of cancer patients.

Oncologists and oncology nurses work together to ensure patients not only receive the medical treatment they need, but also the emotional support to cope with the challenges that come with a cancer diagnosis. The goal is to provide holistic care that addresses the physical, emotional, social, and spiritual aspects of the patient's well-being.

Some responsibilities of oncology nurses include administering chemotherapy, managing side effects, providing education about the disease and treatment options, and coordinating care with other healthcare professionals. They also have to be vigilant about monitoring patients for complications such as infections, since many treatments, like chemotherapy, can weaken the immune system.

Patient Care Management

Patient care management encompasses the comprehensive planning and coordination of healthcare services to meet the needs of individual patients. It is particularly critical when caring for cancer patients, given the complexity of their conditions and treatments.

Effective patient care management often involves creating a personalized care plan that takes into account the patient's diagnosis, treatment regime, potential side effects, and the need for emotional and psychological support. Oncology nurses are central to this process, as they help to identify potential risks and intervene before issues become critical.

Part of patient care management is also understanding the importance of the treatment environment. For patients who are immunocompromised, such as those with neutropenia, it's vital for care managers to ensure a safe space that minimizes exposure to infectious agents. This can influence decisions regarding room assignments and patient pairings on oncology units.

Neutropenia in Cancer Patients

Neutropenia is a condition commonly seen in cancer patients wherein there is an abnormally low count of neutrophils, which are a type of white blood cell crucial for fighting infection. This condition can be a direct result of cancer itself, but it is more often caused by cancer treatments like chemotherapy.

Managing the risks associated with neutropenia involves strict infection control practices. Oncology nurses play a vital role in educating patients and their families about hygiene practices, monitoring patients for signs of infection, and sometimes administering granulocyte-colony stimulating factor (G-CSF) to stimulate the production of white blood cells.

When caring for neutropenic patients, healthcare professionals must take special precautions, such as avoiding the placement of these patients with those who may pose an infection risk—including patients receiving blood transfusions or those recovering from surgery. By carefully pairing such patients with others who have similar immune system challenges, like in the exercise solution with pairing C, the risk of cross-infection can be minimized.