A 25-year-old patient diagnosed with leukemia underwent a bone marrow transplant. Which of the following are interventions specific for post-transplant nursing care?

Check skin turgor and moisture of mucous membranes
Maintain a protective environment
Provide skin care

Explanation

•Total body irradiation (TBI) is given immediately prior to the transplant to eradicate existing disease and to suppress immune reactions. This is a very important pre-transplant nursing care intervention.

•Total body irradiation is another innovative leukemia treatment that often serves as part of the preparation process for leukemia patients who will undergo bone marrow transplant. TBI suppresses the immune system of the patient to prevent the body from rejecting the donated stem cells of which high doses can also help eradicate any remaining leukemia cells in the body.

•All the other options are nursing care measures for the post-transplant phase. Maintaining a protective environment prevents infection.  Visitors shouldn't bring in any fresh fruit or flowers as the patient is immunocompromised, and can increase the risk for infection. Providing skin care is necessary because skin breakdown can occur from profuse diarrhea after the TBI. Checking the turgor and moisture of mucous membranes help maintain fluid and electrolyte balance and promote nutrition.

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