Tom is ready to be discharged from the medical-surgical unit after 5 days of hospitalization. Which client statement indicates to the nurse that Tom understands the discharge teaching about cellular injury?
A. "I do not have to see my doctor unless I have problems."
B. "I can stop taking my antibiotics once I am feeling better."
C. "If I have redness, drainage, or fever, I should call my healthcare provider."
D. "I can return to my normal activities as soon as I go home."
Correct Answer: C. “If I have redness, drainage, or fever, I should call my healthcare provider.”
The knowledge that redness, drainage, or fever — signs of infection associated with cellular injury — require reporting indicates that the client has understood the nurse’s discharge teaching. If a cell is unable to adapt to increased stress, injury results. Cell injury is reversible until a certain threshold where it progresses to cell death. Historically, cell death has been designated into two classes: necrosis and apoptosis. Necrosis is often coined as accidental death as it is generally seen as not controlled by the cell. Apoptosis, on the other hand, is typically viewed as programmed cell death, regulated and controlled.
Option A: Follow-up checkups should be encouraged. Cell growth, division, and death are all important parts of this regulation, and each is highly regulated. Loss of this balance is seen in tumor cells where mechanisms of cell death are avoided, resulting in uncontrolled cell growth. Conversely, conditions where extensive cell death is seen also result in loss of homeostasis, such as in the case of neuronal loss in Alzheimer’s disease.
Option B: The nurse should place an emphasis on antibiotic compliance even if the client feels better. The understanding of cell death and the players involved is a subject of constant research. The better one understands the mechanism of cell death, the more likely it is that knowledge can be integrated into clinical medicine.
Option D: There are usually activity limitations after cellular injury. Chemotherapy treatments with radiation can manipulate these pathways more directly by causing DNA damage that drives the cell to apoptosis. Understanding the basics of cell death allows for a better understanding of how tumor cells may evade death and counter-evade clinically.
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