314 exam 1 Flashcards
SPICES framework is
assessment tool used for older patients
S - sleep disorders
P - Problems eating or feeding
I - Incontinence
C - Confusion
E - Evidence of Falls
S - Skin Breakdown
PQRSTU pain assessment
P - provoking factors
Q - Quality / Quantity
R - Region / Radiation
S - Severity
T - Timing
U - Understanding
older client who live at home maintain independence longer if engaged in ________
strength and flexibility exercises
pain is considered chronic if it has lasted for ______
3 months
cancer pain can either be _____ or ______
acute or chronic
examples of somatic pain
cuts, headaches, pelvic pain
examples of visceral pain
abdominal pain, chest pain, back pain
to best combat dehydration _____ should be drank
water
green tea and grapefruit juice will ______ the effects of doxorubicin
enhance the side effects
_____ should be avoided for pain control in head injuries
opioids
premenopausal women taking tamoxifen are at risk for early _______
osteoporosis
hyperkalemia can be seen on an EKG as _______
higher peaked T waves
_____ race variations are at higher risk for neutropenia when taking Vincristine (oncovin)
Asian
chemotherapy can cause cognitive issues for clients. This is termed ____
chemo - brain
NADIR is when
blood counts are at their lowest during the chemotherapy treatment period
_______ foods should be avoided when taking mechlorethamine
citrus or citric
dastininb may cause an imbalance of ______ and ________
phosphorus and calcium
acetaminophen with codeine is commonly called a _____ type of medication
combination
legal documents and consents should be signed before giving _______
narcotics
when handling chemotherapy drugs you should use _____
PPE
chemotherapy medication infiltrates, apply ______ packs for 15-20 minutes at least 4 times per day
heat packs
In HPV, ____ is used for girls and _____ is used for boys
gardisil, cervarix
vincristine can cause peripheral _______
neuropathy
a patient on rituximab should report ______ immediately
low grade fever
exposed radioactive devices should be placed into a ______
lead container
elderly patients have diminished ______ and ______
taste and smell
most common reason for elderly acute onset confusion
polypharmacy
most common reason for adverse drug events in older adults
polypharmacy
older patients may be ______ history givers
poor recollection of history
avoid _______ patients at all cost
restraining
for older patients _______ restraints every ________
release restraints every 1-2 hours and walk/turn/toilet
check patient every _________ when under restraints
30 - 60 minutes
recidivism definition
relapse to criminal behavior
______ leads to high readmission rate and reoccurring health co morbidities
poorly coordinated care
developmental tasks definition
transitions that occur in normal successful adulthood
transitions definition
health or illness events that require an individual to make modifications in his or her lifestyle
social age defines
what is considered an appropriate behavior in each stage of the life cycle.
______ is the leading cause of disability
pain
hierarchy of pain measures in order
- obtain a self-report
- search for potential causes
- observe behaviors
- obtain information from others
- attempt a trial of pain medication
pain assessment in advanced dementia scale - BNFBC
breathing -
negative vocalization -
facial expression -
body language -
consolability -
caffeine ______ the effects of acetaminophen
enhances absorption and strengthens analgesic effects of acetaminophen
contraceptives ______ the effects of acetaminophen
reduce
maximum daily dosage of ibuprofen if prescribed
3200 mg per 24 hours if prescribed
maximum daily dosage of ibuprofen if used OTC
1200 mg OTC
ibuprofen mechanism of action
blocks cox 1 and cox 2 to inhibit prostaglandins
overdose protocol for ibuprofen
Time and charcoal lavage
Reye’s syndrome cut off age
19 years or younger
unique side effect of aspirin
tinnitus
NSAID’s cause _____ which result in _____ blood pressure
sodium retention which results in increased blood pressure.
maximum daily dosages of celecoxib and valdecoxib
800 mg per day
activation of serotonin receptors in the brain cause ______
vasoconstriction and increased blood pressure
5-HT receptor agonists do what
activates serotonin receptors in the brain
Sumatriptan mechanism of action
5-HT receptor agonists that vasoconstricts cerebral vassals to relieve headaches
avoid use of opioids if the patient has ______ or ______
head trauma or asthma
expected morphine dosage
2-10 mg IV
maximum dosage of morphine per day
30 mg IV maximum per day
before administering morphine, make sure that _______
legal documents are signed
two serious adverse reactions to morphine include
respiratory depression and hypotension (shock)
_______ indicate morphine overdose
pinpoint pupils
overdose of meperidine may lead to _______ activity
seizure activity
meperidine has a ______ than morphine
shorter duration of action
with hydromorphone injection _______ direct solution injection
avoid
butorphanol, buprenorphine, and nalbuphine
less euphoric than morphine and meperidine, less addictive, used in patients with history of opioid abuse and addiction
butorphanol, buprenorphine, and nalbuphine last _____ hours
5 hours of duration
Dtap is
diphtheria, tetanus, and pertussis vaccine for children 6 weeks to 6 years old
Tdap is
tetanus, diphtheria, and pertussis vaccine for ages 10 and up
Directed radiation therapy does what
slows and stops cell division at the tumor site
Debulking
palliative treatment for patients whom the cancer is not reversable (improve quality of life but not cure)
Proton beam is direct radiation therapy specifically to the tumor site. What is used to cut it out?
gamma knife therapy directly
Brachytherapy is ________
removal radiation source is in direct contact with the patient so the patient is considered to be radioactive
If the source of extraction is external, then the patient is not considered _______
radioactive
Some effects of radiation take ______ to develop
years
antineoplastic drugs are also referred to as ______
carpet bombers
Biologic response modifiers (BRM’s) work to
boost specific immune response
alkylating chemotherapy agents must ______ per day
drink 2 liters of fluid per day
alkylating chemotherapy agents might cause _______
peripheral neuropathy
The main alkylating agent of focus is _______
Mechlorethamine HCL (Mustargen)
Anthracyclines - Doxorubicin toxicity leads to ____
cardio toxicity
give doxorubicin through ____ lines only
large bore intravenous devices such as PICC lines and central lines
green tea ______ doxorubicin’s effects
enhances
St. John’s wort _______ doxorubicin’s effects
reduces
4 G’s ______ doxorubicin’s effects
reduces
an expected side effect of doxorubicin is _____ urine
pink or red
doxorubicin causes high grade neutropenia in _____ patients
Asian
Antimetabolic drug of focus
Fluorouracil (5-FU)
Fluorouracil possess high risk for
pancytopenia - increased bleeding, increased risk for infection, and anemia
pancytopenia trifecta
neutropenia
anemia
thrombocytopenia
Plant alkaloid drug of focus
Vincristine (Oncovin)
Vincristine mechanism of action
forces cancer cells into apoptosis
Fluorouracil (5-FU) mechanism of action
stops DNA synthesis of cancer cells
Vincristine is known to cause
peripheral neuropathy
Leucovorin (folate analog) is administered to prevent _____ of vincristine
toxic effects
Androgens are used for (chemotherapy)
used for advanced breast cancer in PRE menopausal women
Antiestrogens are used for (chemotherapy)
blocking estrogen in estrogen dependent breast cancers
SERMS are used for (chemotherapy)
similar to anti estrogens but with fewer low estrogen side effects in women
Luteinizing hormone uses (chemotherapy)
suppresses FSH, and LH from pituitary. In men has the effect of reducing prostate size; in women will decrease ovary size.
Aromatase Inhibitors uses (chemotherapy)
blocks conversion of testosterone to estrogen -> used for estrogen dependent tumors, commonly used in treatment of breast cancer in POST menopausal women.
Tamoxifen may cause _____ and risk of fatty liver disease
hepatoxicity and so liver enzymes should be monitored
In women, Tamoxifen has been liked to _______
endometrial cancer
Tamoxifen has been shown to increase risk of _____ in stagnated patients
DVT
HPV vaccine for girls 9 to 26
gardisil 9
HPV vaccine for boys 9 to 26
cervarix
Tyrosine Kinases Inhibitors stem -
-nib
dasatinib
dasatinib mechanism of action
blocks atp binding sites to prevent kinase activity
kinases (enzymes) are
enzymes that carry out phosphorylation in metabolic reactions
dasatinib causes (electrolytes)
electrolyte imbalances of calcium and phosphorus
dasatinib causes (bone)
myelosuppression - assess for pancytopenia
with all chemotherapy drugs, avoid use of (pharm)
proton pump inhibitors and antiacids
Imatinib assess for
cardiac dysrhythmia
pancytopenia
dasatinib assess for
cardiac dysrhythmia
pancytopenia
bevacizumab (monoclonal antibody) mechanism of action
binds to VEGF which is needed for blood vessel growth within the tumor and stops it
same side effect profile as other chemo drugs
-mab unique side effect (clotting)
may increase INR values if taken with warfarin (vastly increased bleeding)
drug with highest risk for tumor lysis syndrome
rituximab (monoclonal antibody)
Interferons ____ white blood cells to fight cancer
stimulates and assists white blood cells to fight cancer
type 1 alpha interferons produced by ______
leukocytes
type 2 beta interferons produced by _____
fibroblasts
