Adult Care 2

Question 1

Iron Deficiency Anemia Causes

Answer 1

Acute blood, chronic blood loss, and inadequate nutrition

Question 2

Routing Screening for Cancer

Answer 2

General Check-Up every 3 years age 20-39 and annually for age 40 and above
Mammogram (40 yrs/10qyrs)
GYN (21 yrs/qyr)
prostat (50 yr/qyr)

Question 3

CAUTION

Answer 3

C - Change in bowel and bladder habits
A - Sore that does not heal
U - Unusual bleeding or discharge
T - Thickening or a lump in breast or elsewhere
I - Indigestion or difficulty swallowing
O - Obvious change in wart or mole
N - Nagging cough or hoarseness

Question 4

GI Upset - N/V, stomatitis, anorexia, mucositis, diarrhea Care

Answer 4

Assess intake, might do TPN if they are not eating PO
Considered when they cannot tolerate eating due to stomatitis, N/V, etc

Use antiemetic prophylactically (decadron, benadryl, and ativan) prior to chemo

Anorexia: find food that they like

N/V: antiemetic, peppermint or ginger tea

Stomatitis or Oral mucositis: miracle mouthwash (contains lidocaine)

Diarrhea: Don’t give them anything red, if they vomit or diarrhea, you don’t know if it is blood.
Test for C. Diff

Question 5

Electrolyte imbalance for Tumor Lysis

Answer 5

Hyperkalemia (dysrhythmias), hyperuricemia (bladder/renal issues) and hyperphosphatemia (renal damage, increased risk for MI) with secondary hypocalcemia (muscle cramps, bone/joint pain).

Check blood work every 3 hrs once chemo starts

Question 6

Meds use for Tumor Lysis Syndrome

Answer 6

Preventative measure
Allopurinol
Urinary alkalinization
Prevents uric acid from crystallizing in the kidneys
Commonly given orally 2 to 4 days prior to chemotherapy

Hydration (forced diuresis with IV fluids if necessary)

Keep urine output at least 150 mL/hr.

Question 7

Biphosphate Action

Answer 7

Slow Bone resorption

Question 8

Bisphosphate Education

Answer 8

Sit up after taking for 30 min, take in empty stomach, and take with water

Do not take for long term; it can lead to osteonecrosis or long-bone fx

Question 9

RA S/S

Answer 9

Early
Inflammation of the joint, fever, weakness fatigue, paresthesia

Late
Joint deformities, swan neck (severe deformity of hand)
anemia, subq nodules, peripheral neuropathy, etc
Sjogren’s syndrome (dry syndrome)
Felty’s syndrome (hepatosplenomegaly and leukopenia)
Chaplin’s syndrome (rheumatoid nodules in the lungs)

Question 10

OA S/S

Answer 10

S/S: bone spur, crepitus, stiffness, fluid build-up, unilateral,

Question 11

OA vs RA

Answer 11

RA is autoimmune and fast onset (weeks or months) and OA is wear and tear (years)

RA affect any age and OA affect ppl over 40

RA s/s is systematic and OA s/s is localized at the joint

RA affects joints throughout the body and OA affect the joints used in weight bearing

Question 12

Lab for RA

Answer 12

ANA, rheumatoid factor, erythrocyte sedimentation rate (ESR), and C-reactive protein

Question 13

NSAID S/E

Answer 13

SE: tinnitus, stomach irritation, heart problems, and liver and kidney damage

Question 14

DMARDS S/E

Answer 14

SE: Liver damage, bone marrow suppression, and severe lung infections

Question 15

Fish Oil and Plant Oil S/E

Answer 15

Fish Oil SE: nausea, belching, and fishy taste in the mouth
Plant Oil SE: Nausea, diarrhea, and gas

Question 16

Steroids S/E and Action

Answer 16

Reduce inflammation, pain, and slow joint damage
Can only administer 4/yr
SE: thinning of bones, weight gain, and diabetes

Question 17

Joint replacement Pre-Op

Answer 17

Assess for mobility issues (need for assistive/adaptive device)

Stop NSAIDS, Vit C/E, hormone replacement therapy or oral contraceptives one week before surgery.

Question 18

Prevent DVT

Answer 18

Lovenox

Question 19

LMWH

Answer 19

LMWH
Normal INR: 2-3
Normal PTT: 1.5-2
Monitor for bleeding

Question 20

Iron Deficiency Cause

Answer 20

acute blood loss, chronic blood loss, inadequate nutrition

Consider GI bleed first `

Question 21

Iron Deficiency Sx

Answer 21

weakness early on, brittle spooning fingernails, dry and cracked mucous membranes, soreness of tongue,

Question 22

Hemolytic Anemia Causes

Answer 22

Hemolysis, premature destruction of RBC, autoimmune antibodies, burns, exposure to toxic chemicals, sickle cell

Question 23

Anemia Chronic Disease Causes

Answer 23

Malnutrition: missing folic acid and vit C

Infection/inflammation: decreased EPO, impaired transport to bone marrow

Cancer: chemo side effects suppress bone marrow

Renal: decreased erythropoiesis and RBC survival

Liver: alcohol toxicity, decreased iron storage

Question 24

Anemia Chronic Disease Mediation

Answer 24

Ferrous sulfate

Renal: erythropoietin supplements

Question 25

Pernicious Anemia Cause

Answer 25

Gastrectomy, small bowel disease, h. pylori, prolonged antacids, vegetarian diet, heavy alcohol ingestion, cigarette smoking

Question 26

Pernicious Anemia Sx

Answer 26

Infection, mood swings, general anemic sx, weight loss, sore mouth, beefy red tongue, abdominal pain, cardiac/gi/kidney issues

Question 27

Pernicious anemia Medication

Answer 27

B-12 injection lifetime treatment (not tablets! They wont work)

Question 28

Folic Acid Anemia Causes

Answer 28

Malabsorption syndromes, poor nutrition, alcoholism, malignancies

Malnourished from fat diets that limit vegetables (humans are totally dependent on nutritional intake of folic acid)

Question 29

Folic Acid Anemia

Answer 29

Scales and fissures in mouth

Stomatitis

Painful ulceration of buccal mucosa and tongue

Dysphagia

Flatulence/watery diarrhea

Question 30

B symptoms

Answer 30

Fevers, night sweats, unintentional weight loss, infection

Question 31

CML and CLL treatment

Answer 31

Hydroxyurea in early stages

Bone marrow transplant

Question 32

Multiple Myeloma SX

Answer 32

Most common presentation is bone pain

Pathological fractures

Question 33

Multiple Myeloma Diagnosis

Answer 33

CRAB

Calcium elevated

Renal insufficiency

Anemia

Bone lesions