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H & Illness 4: A & C illness > Cellular Regulation : Nursing Care > Flashcards

Cellular Regulation : Nursing Care Flashcards

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1
Q

zimpaired cellular regulation : general info
what is the one thing we do first ?

A

make the diagnosis : we do this thorugh biopsy

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2
Q

recall that one thing we have to do is make the diagnosis when it comes to impaired cellular regulation, what else?

A

further testing to help with grading and staging, TNM classification

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3
Q

what is our goal of treatment ? for impaired cellular regulation ?

A

cure, control, or palliation, minimize tx side effects

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4
Q

what is the methods of treatment when it comes to impaired cellular regulation

A

surgery, radiation therapy, chemotherapy, hormonal therpahy, targeted theraphy, biologic theraphy, and bone marrow or hematopoietic stem cell transplants

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5
Q

identify if below are methods of treatments when it comes to impaired cellular regulation:

surgery, radiation therapy, chemotherapy, hormonal therapy, targeted therapy, biologic therapy, and bone marrow or hematopoietic stem cell transplants

A

yes all of the above

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6
Q

methods of tx : are surgery, radiation therapy, chemotherapy, hormonal therapy, targeted therapy, biologic therapy, and bone marrow or hematopoietic stem cell transplants

A

these support cel recovery with hematopoietic growth factors

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7
Q

recall that surgery could be a use of treatment of cancer, what determines this ?

A

surgery is dependent on where the cancer is

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8
Q

true or false. people with cancer are not only in one unit, they are scattered everywhere in terms of placements.

A

true

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9
Q

_____ is one of the things help suppress bone marow to get good cells , we are talking to immunity here and less damage to the body as possible.

A

gastrin

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10
Q

effects of cancer and cancer treatments :
immunity and clotting what undergoes this

A

WBC - neutrophil - neutropenia - nadir- absolute neutrophil count” ( ANC )
- anemia
-thrombocytopenia

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11
Q

thinking abt anemia , along with low WBC they typically have low blood cells count why ?

A

due to the chemo

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12
Q

what are symptoms of anemia ?

A

this is a low hemoglobin ( therefore they may feel tired, SOB, no energy )

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13
Q

what does nadir mean ?

A

lowest point of white blood cell count

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14
Q

why is absolute neutrophil count important ?

A

its important since it shows us how immunocompoms the patient is

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15
Q

true or false. we could get an ANC at 0 which means the pt has 0 immune system.

A

true

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16
Q

true or false. Cancer treatment could also cause imapired clotting, they do not have platelets, which means they do not stop the body from bleeding.

A

true

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17
Q

is gi affected during cancer treatments ?

A

yes : cachexia, functioning of gi tract, and liver is affected as well

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18
Q

why is cachexia occurring ?

A

the body spends a lot of energy and not able to absorb food and give energy
( people become thin )

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19
Q

functioning of gi tract , how does this affect the body ?

A

high metabollic rate, no appetite, and ability to change and can be nauseated

( they really have to fight themselves to get nutrients in )

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20
Q

functioning of the liver : how does this impact the body

A

impacts metabolic functioning ( they cannot give food, and keep fat and get energy )

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21
Q

what undergoes peripheral nerve sensory perception
as an effect of cancer treatment

A

( rare ) pt may have tumor in spine
( common neurotoxic chemo - reduced sensory perception )

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22
Q

( rare ) pt may tumor in spine ( can u explain this )

A

change in their peripheral nerve, peripheral system , because of the tracts running in the core

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23
Q

true or false. sensation in their feet, numbers and going downstairs ( more likely to trip )
neuropathic pain ( terrible pain )

A

true

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24
Q

central motor and sensory function is one of the effects of cancer/cancer treatments what undergoes this

A

cancer invades bone or brain ( bone fractures, ) hypercalcemia

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25
Q

what happen in central motor and sensory function

A

much more likely to have a bone fracture , even if they trip ( what there bone from treatment ) much more likely going to break

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26
Q

true or false. patients mobility of the pt ( anything that has to do with central or sensory ) think abt walking and moving.

A

true

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27
Q

what undergoes resp function

A

moving and expanding of the lungs will be affected

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28
Q

what undergoes resp funcion

A

tumor in lung
pleural effusion
compression on vessels, lymph glands

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29
Q

what could tumor in the lung do in terms of resp?

A

can impair their breathing , very common in cancer ( even if it has nothing to do with the lungs )

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30
Q

What is happening within the pleural effusion

A

very common in cancer, ( even if it has nothing to do with the lungs ) , if there is a tumour compressing on vessels ( impairs their lungs, their breathing )

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31
Q

true or false. is cancer of the heart common ?

A

no it’s usually not common

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32
Q

can drugs be somehow cardiac toxic ( hard on the heart ) what can happen ?

A

can make scar tissue, or make a valve not work as it should

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33
Q

if it’s a severe impact , the pt may impact a heart failure related to the treatment to their cancer.

A

cardiac function

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34
Q

comfort and quality of life is very important. why is it important for our pt ?

A

cancer pain - management of the pain and the side effects of the meds to treatments ( drowsiness, constipation )

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35
Q

true or false. if we treat cancer , we have to treat side effects that comes with the drugs ) what typically goes away ?

A

drowsiness typically goes away however constipation doesnt go away

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36
Q

cancer pain
- can be severe , think of pt’s quality of life

what meds do u think they’ll be on in terms of pain?

A

narcotics ( morphine, hydromorphone/dilaudid, fentanyl )

adjuvants ( additional meds )

doses can be large

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37
Q

what do u consider in cancer pain ?

A

effectiveness and side effects

regular dosing and PRN for breakthrough
- oral ( po-pll, liquid ) easiet

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38
Q

true or false. we want to be consistent ( q-4 -q6 ) for breakthrough ( alot of infuse tranfusions especially if its palliative pain )

A

true

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39
Q

continious, infusions, fentanyl transdermal patch are typically seen in cancer pain

A

yep true

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40
Q

chemo adminsitration

A

protocol
handling precautions
specific RN training

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41
Q

often combo of drugs given
timing is really important
is true in terms of chemo admin

A

yes true

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42
Q

what are routes for chemo to go through

A

IV- peripheral IV, tunneled catheters, PICC, port a cath

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43
Q

what are the complications for chemo?

A

extravasation injury from infiltration of chemo meds

irritant/vesicant

pros/cons to peripheral IV access compared to venous access device

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44
Q

true or false. when you have a PICC line u do not want to be wet ( the insertion site ) because why ?

A

true, because it increases the risk of infection

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45
Q

could we take bloodwork from picc line?

A

yes we can

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46
Q

what is the line that is known to be “ little kid friendly “

A

port a cath

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47
Q

port a cath has no ____ coming

primarily what they do for kids

A

line , port a cath

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48
Q

effects of chemo on normal tissue

what is ur body feeling

A

body responds to the destruction of cells

fatigue, anorexia, taste alteration

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49
Q

effects of chemo on normal tissue

what are some adverse effects

A

acute, delayed, or chronic, alopecia

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50
Q

what is a cold cap therpahy intially help?

A

decrease the chance of losing hair ( encourage wearing hats, wigs, scarfs )

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51
Q

true or false. a good example of a chronic side effect of chemo on normal tissue is heart failure : peripheral neuropathy ( there feet is numb and tightly and cannot walk downstairs feeling normal )

A

true

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52
Q

can these all occur during cancer ?

nausea and vomitting
diarrhea
nutrition

what undergoes eating and food choice?

A

eating
- food appearance and smell

food choice
-diarrhea-food, fluid intake——– imodium
-nutritious & able to eat/tolerate

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53
Q

what is one antiemetic that is used during cancer treatments?

A

ondansetron

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54
Q

what is the route given for ondansetron ?

A

either PO or IV

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55
Q

what is the appearance like typically in cancer

A

cachexic, muscle mass, moon face

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56
Q

during weight assesment we have to think “ weight “ is it body mass or retained fluid ?” ( calorie counts )

A

yes

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57
Q

Recall that focusing on muscle mass and see if they maintain there weight is important

A

small frequent meals ( avoid fatty foods ) since it could bring in more nausea, avoid hot foods, or spicy foods, another thing is DO NOT LAY DOWN after eating.

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58
Q

JUST READ : to avoid hot food
- eat more cold or luke warm food

  • hot food carries strong smells and people going through treatments have strong smell ( make them sick )
A
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59
Q

milkshake, ensure, and thing u can add to add extra protein or calories should be encourage

A

yes

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60
Q

what is a better position after eating ?

A

sitting up is better when it starts to digest- clears your stomach dont drink ur fluid with the meal ( fill ur stomach ) try to have nutrients and then drink ur water

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61
Q

is radiation theraphy painful ?

A

yes it is painful

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62
Q

what is radiation therapy ?

A

kill cancer cells, want minimal effect on surrounding ( normal ) cells

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63
Q

can radiation therapy be local or systemic ?

A

yes it can be local or systemic

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64
Q

radiation therapy method of delivery :

A

external radiation
internal radiation - brachytherpahy ( seeds, ribbons, capsules )
radiosurgery, gamma knife

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65
Q

during an external beam radiation , there is a tattoo, what does that indicate?

A

permanent tattoo as part of tattoo and done the treatment they turn into a different type of tattoo

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66
Q

radiation effects & treatment acute & long term

A

site of radiation– organ or body site with cancer

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67
Q

what is skin for radiation effects & treatment : acute & long term

A

skin– radiation dermatitis; dry, itchy ( pruritis ), may break down

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68
Q

what undergoes radiation effects and treatment

under skin of radiation – organ or body site with cancer

A

tattoo/ink markings
skin protection- cleaning
—- avoid friction
—-photosensitive & heat sensitive

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69
Q

head and neck – xerostomia ( dry mouth, ) tooth decay- dental care prior to tx

A

true

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70
Q

what is the systemic effects

A

fatigue
altered taste
bone marrow suppression

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71
Q

where are beams going through?

A

through our skin , ( think abt their skin ) they can develop radiation dermatitis

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72
Q

what can radiation dermatitis lead to ?

A

lead to an open wound because radiation has broken down into those skin cells

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73
Q

if they have a tattoo or ink marking ( do not wash ) why do we want not wash it ?

A

we need it for treatment

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74
Q

when it comes to cleaning, be careful !

A

don’t exfoliate and scented things ( do not use them ) !it got dyes –> so be careful!

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75
Q

how do we avoid friction ?

A

lose fitting clothing is good, no tight belts, breast cancer have problems ( wearing a bra ( friction of the material ) have to find alternative

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76
Q

head and neck cancer - use radiation is their mouth ( they have tooth decay from it )

A

true

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77
Q

skin should be moisturized ( external beam radiation )

A

yes this is true

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78
Q

true or false. avoid alcohol-based cleaners/creams, avoid retinol creams

A

true

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79
Q

true or false. avoid exposure to sun and heat.

A

true

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80
Q

radiation therapy : sealed implant “

safety -

A

reduce exposure to ionizing radiation
– intensity, duration, closeness

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81
Q

radiation therapy “sealed implant”

if they have implant in them

A

they are radioactive, with the hope of consistently killing the cancer

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82
Q

is it true or false. implant cannot be shut off anytime–> we have to be aware of following policies from xray exposure and any visitors

A

true

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83
Q

true or false. if a pt has brachytherapy ( internal radiation therapy ) consider safety of others and the RN

A

true

84
Q

if a pt has brachytherapy ( internal radiation therapy ) consider safety of others and the RN

A

radioactive isotopes
pt room, signage
visitor restriction
RN- dosimeter film badge

85
Q

dosimeter is what ?

A

how much radiation the person is exposed to ( just for protection )

86
Q

urinated or stool is not radioactive
- we have to think abt it?

A

yes we have to think abt it

87
Q

dosimeter film badge leads to what ?

A

lead apron and lead container

88
Q

if they have implant in them they are what ?

A

radioactive, with the hope of consistently killing the cancer

89
Q

myelosuppression & neutropenia WBC - fight infection

A

overgrowth of pts own normal flora ( microbiome )

cross-contamination/prevent transmission of organisms fr others

90
Q

what is the general care * hand washing
- hospital room/environment
-equipment

A

true

91
Q

what undergoes Ng assessment

A

head to toe
VS- temp
bloodwork
protocols - surveillance or situational : culture/CXR/swab atbx

92
Q

true or false. visitors and care for self when discharge home undergoes myelosuppression & neutropenia.

A

true

93
Q

true or false. clean atleast once a day, thermometer, stethoscope ( have their own equipment in their room ) prevents cross contamination

A

true

94
Q

abnormally low white blood cell count

A

not fighting infection
when they do get it overgrowth of their own normal flora

95
Q

is this true or false : - careful of cross contamination ( if they are myelosuppresion or nuetropnia ( o or 2.5 ) special unit
- the pt on our unit has no immune system - if we do do this ( no visitors who has been sick. chicken pox, measles, or ask abt immunizations ) to make sure that everybody is protective from any skinless

A

true

96
Q

this would be recommended?( daily blood work , usually wbc, anc ( neutrophil ) hemoglobin and platelets )

A

yes

97
Q

thrombocytopenia is what ?

A

platelets - clotting
prevent injury / prevent bleeding-safety
personal care
-shaving
-oral care

98
Q

eating mouth
would be seen within thrombocytopenia

what undergoes it

A

eating/mouth
-stomatitis/mucositis

99
Q

its important to what when thrombocytopenia

A

assess own body
blowing nose
activities
rectal
- prevent constipation

100
Q

is this true : for flossing - gentle ( very gently as soon as u cut their skin or gums ( they bleed alot )
eating or mouth care - from the chemo and radiation ( make sure we are gently and doing a lot of rinsing )
tap water or salt water ( make sure they know how to asses their own body )
- anything swollen

A

true

101
Q

blowling their nose ( dont close nostril and blow hard, intra thoracic pressure, bleed through nose or any aneurysm they do not know abt - it could lead to bleeding )

A

yes

102
Q

any activities - cutting knives will be something to avoid

A

true

103
Q

rectal- any hemmoroid can be severe ( no enemas )

A

yes

104
Q

acute complications of cancer it’s tx

rn role is what ?

A

assess patient ( recent hx, h2toe assessment, lab work, dx test result , and listen to patient/family )

105
Q

acute complications of cancer and it’s tx

what undergoes assesment

A

share your findings and thoughts , early dx, immediate; can be fatal

106
Q

acute complications of cancer & it’s tx include

A
  • Sepsis/septicemia
  • DIC disseminated intravascular coagulation
  • SIADH Syndrome of antidiuretic hormone
  • SCC Spinal cord compression
107
Q

are these typically seen as acute complications

A

hypercalcemia
superior vena cava syndrome
tumor lysis syndrome

108
Q

would this occur during acute complication of cancer & treatment

impaired immunity

overwhelming infection –organisms in body

low grade fever 38.0 may be only sign

Hi mortality rate

A

Yes

109
Q

what protocol/printed orders

A

culture, cxr, swabs
start antibiotics

110
Q

if they get a fever or high temperature
- it could kill them
-septic shock ( high mortality rate, happens fast and body is unable to mount any response )

A

yes this is true

111
Q

if the ogranisms comes back and its not covered by the drug
- doctor will change it ( not a bacteria they found, maybe it was a fungal infection )
—> change orders and start flagel etc.

A

true

112
Q

swabs — where can you do it in the site?

A

rectum , nose, and mouth

113
Q

DIC is often called by

A

sepsis

114
Q

DIC what is the description?

A

abnormal clotting & then bleeding- address cause and correct coag abnormalities

115
Q

what type of skin can we see under DIC

A

petechiae, purpura

116
Q

SIADH what type of sodium do we have ?

A

low sodium, diluted blood

117
Q

what is it like in siadh?

A

abnormal anti diuretic hormone soaked inside

118
Q

siadh patients hold on to what ?

A

holding on to a bunch of water therefore diluting that blood

119
Q

what is our interventions in a siadh patient ?

A

restrict fluid intake- in terms of treatment, get sodium levels higher - giving 3 percent normal saline

120
Q

if a pt has siadh - weight is going up ( because of fluid, not because of eating food )
the person may feel things because of low sodium, -= weakness nausea and vomiting

A

true

121
Q

if left untreated 0 seizures and coma ( try to get sodium back up. ) and can restrict fluid

A

true

122
Q

excessive ADH secretion

A

hyponatremia w low serum osmolality

hypervolemic is often transcient due to nautretic mechanisms

123
Q

SIADH: causes

A

CNS disorders
tumors
drugs
surgery
infections
genetics

124
Q

what is the treatment for SIADH?

A

adh antagonist

125
Q

what is the sign and symptoms of SIADH

A

N & V, obtundation. H.A , seizure, resp arrest, coma

excess water retention can cause brain swelling and neuron dysfunction

126
Q

spinal cord compression typically cause what pain?

A

back pain

neurologic changes- affect spinal cord nerves
-muscle strength
‘heaviness’
sensation
gait
gi/gu issues
deep tendon reflexes

127
Q

this often happens if a pt has a tumor
- cancer that has a cancer in the spinal cord - _____and ___________- rare

A

parapelegic and intraplagic

128
Q

just read ! weaker and muscle strength - proceed heaviness and weight usually in the limbs - sensation will decrease
- often times ( they have gait issues —> limping or dragging )
person can also have gi/gu symptoms depending on the location due to spinal cord ( constipation, incontinent of stoll or urine ) they do not have sensation to go to the bathroom

A

true

129
Q

two thins to fix : if possible is surgery ( surgery on the spinal cord is risky ) to resect or remove this tumour,
radiation is the other thing ( to try to shrink the tumor )

A

yes

130
Q

what is hypercalcemia ? why is this happening ( and what type of cancer is this more common in )?

A

most likely happen if the person has cancer if its involving bone
- we start to see there calcium levels go high
and the big thing it could do is fail ur kidneys

131
Q

true or false. hypercalcemia are type of cancer that involves the bone and others

A

true

132
Q

what is important when it comes to hypercalcemia

A

hydration and mobility ( because immbolity and dehydration could occur –> exacerbate )

133
Q

true or false. potential renal failure could occur when a pt has hypercalcemia

A

yes this si true

134
Q

what is the treatment for hypercalcemia

A

hydration diuretic biphosphonate

135
Q

why would hydration and giving diuretic to a hypercalcemia be beneficial to them ?

A

to keep them hydrated, and giving diuretic after could help them flush the system

136
Q

what does biphosphonate do ?

A

medication where it kinda slows down osteoclast

137
Q

what is superior vena cava syndrome

A

this is when the tumor is in a position where it grows compresses on the superior vena cava

138
Q

superior vena cava syndrome how does this cause complication ?

A

obstructs the vena cava- this is seen in the chest xray , often with lung cancer or hodgkins or non hodgkins

139
Q

what is the treatment for superior vena cava ?

A

treatments is radiation ( to try an shrink that obstruction tumor )

could also undergo chemo

140
Q

true or false. cvc could occur gradual or quickly.

A

true

141
Q

what is tumor lysis syndrome ?

A

this is a metabollic complication- can cause fatal biochemical changes

142
Q

what is our treatment goals when it comes to tumor lysis syndrome

A

prevent kidney failure
prevent severe electrolyte imbalance

143
Q

what are we looking at, when a pt has tumor lysis syndrome

A

look at their ins and outs and have a good look at their resp system

ausculate ( any crackles, sob, are they needing more oxy, edema)

144
Q

is this true or false. to prevent kidney damage to a pt who has tumor lysis syndrome, give iv fluid , give alluporinol and treat gout- this helps uric acid levels

A

true

145
Q

what is tumor lysis syndrome triggered by usually?

A

this is triggered by chemo- too effective too quickly

this usually happens within 24 - 48 hrs

146
Q

how long can it persist for ( tumor lysis syndrome ) after chemo

A

can persists 5 to 7 days ( potassium has been depleted as well )

147
Q

release of potassium and extracellular fluid causes what ?

A

causes fluid ( high potassium and uric acid ) increase lower production of uric acid

148
Q

what are the two types of breast cancer treatment ?

A

surgery
- breast conservingpumpectomy and partial mastectomy
- simple mastectomy
-modified radical mastectomy
surgeon - clear margins “lymph nodes”

149
Q

true or false. : the cancer remains
invasive is the most common - thats where it spreads ( depends on where the cancer is )
one of them is surgery and they often have chemo - might also have radiation and oral meds
- this is a lot but everybody treatment looks different

A

true

150
Q

what is this describing :have been spread

A

metasisize

151
Q

what happens in terms of surgery ( cancer )

A

cut out and removes the cancer ( one of them is breast conserving )

lung balectomy ( cut out that part )

partial mastectomy - part of that cancer and a bit more of the breast

152
Q

is this true or false: and would this be a good outcome or bad
?
surgery has been done, they took out the cancer and they look out all around ( found no cancer ) clear margins

A

well no facking shat bruh

153
Q

aside from surgery what are other options in terms of treatment for breast cancer

A

chemo
radiation( primary or brachytheraphy )
oral medications
reconstructive

154
Q

what undergoes oral medications

A

hormonal therapy , estrogen receptor blockers, biological and targeted therapy

155
Q

what is a lymph node dissection ?

A

if dye can travel like that ( so can cancer ) lymph ode being removed form the body is a huge deal

156
Q

what is a lymph edema ?

A

swelling ( this is life long ) we want t avoid this , less lymph nodes -loss of chance of lymphedema

157
Q

what does alnd stand for ? and what is it

A

remove 12-20 nodes
auxillary lymph node dissection

158
Q

what is slnd

A

sentinal lymph node dissection

only nodes that drain from tumom are removed and sent for pathology ( 1-4ish)

159
Q

true or false. more nodes are removed if cancer cells are found in sentinel nodes
- results in lower rates of lymphedema

A

true

160
Q

define if this is true description amonst slnd

asentinal lymph node dissection
- lymph node closest to the tumor ( look closest to the tumor if there is cancer 2 cm away, and 10 cm away, its very likely will go tot he 2cm one )
—> this is what there getting to ( look at that, which nodes drains closely to the tumor area ) - we want to stop any transmission
- they will be in the OR when they do this

( take that sentinal ymph node, and send to the lab ) - look quickly
( inject dye closest to the tumor, look to see where does that travel ? )

A

yes this is true

161
Q

what is this describing : this is a surgery cut and remove ( fat skin from the wall of abdomen )

A

Reconstructive breast surgery

162
Q

reconstructive breast surgery

define its description

A

fat, skin and blood vessels cut from the wall of the lower abdomen and moved up to reconstruct the breast. no muscle is cut or removed.

163
Q

true or false. during reconstructive breast surgery, blood vessels of the flap are carefully reattached to blood vessels in the chest wall

A

yes this is true and we have to assess the perfusion

164
Q

why is it important to assess perfusion after reconstructive breast surgery

A

they have to reattach blood vessels
- make sure it is still attach and perfusion is going through ( or else this flap will die and not be able to survive )

165
Q

postop mastectomy nursing care

surgical site - incisions and drains
what undergoes this

A

incision, flap, drain and tubing

166
Q

is this okay to do ? discharge home with drains in place- teach family to empty drain
- color and amount

A

yes this is okay to do postop mastectomy

167
Q

what we must the pt do that we have to initiate ?

A

follow up appt- dr assessment of incision, remove the drain

168
Q

what is usually the pain postop mastectomy

A

usually mild, post op 4 to 5 ( no need for pain killer )

169
Q

what is usual sleeping postion of post op mastectomy pt

A

usually by their side , learning forward ( works )

170
Q

what is the a big risk of someone who got mastectomy postop

A

big risk of lymphedema ( lymph nodes ) this is not go away ( life long )

171
Q

what is highly enoucourage postop mastectomy

A

postop exercises adn moblity

172
Q

post op mastectomy just read: kept in the person, for about 5 days post op or if the drains have been less than 50 mls per 3 days
- nothing more to drain
teach them abt that

A
173
Q

just read as well : we want the insicision dry and drain ( no big shower, keep it dry )
- keep the flap dry and drian tubing ( stays in ) and doesnt come out
these people has to be taught how to empty these drains ( going to go home ) for 24 hours or so
- go home and will have drains for a couple of days ( empty drain twice a day , how much it is and the colour )
- if its ever frank blood ( pure — reed ) this is an emergency

A

YUH

174
Q

Post mastectomy : restore arm mobility, prevent lymphedema : in this section we talked about goals. What is our goals in terms of this ?

A

prevent contractures and muscle shortening, improve lymph and blood circulation ( prevent lymphedema )

175
Q

what is the estimated time to gradual increase of function for post mastectomy in order to restore arm mobility, and prevent lymphedema ?

A

gradual increase of function over 4-6 weeks

176
Q

what is the nursing interventions - affected arm

A

analgesics before exercise
warm water relaxes muscles
elevate arm post op

177
Q

for nursing interventions in order to prevent lymphedema : what other things should we implement?

A

no elastic bandages post op
avoid the sun and trauma
no bp or venipuncture

178
Q

true or false. it is important to teach pts to when to seek medical attention.

A

yes no shat

179
Q

what are some postmastectomy exercises?

A

hand wall climbing
rope turning
side bends
shoulder blade squeeze

180
Q

how many stages does lymphedema have ?

A

stage 1 to stage 4

181
Q

what is stage 1 lymphedema ? and what abt stage 4 ?

A

1) least signifiant
4) is most significant, very edmatous

182
Q

what do we want to prevent during post mastectomy other than lymphedema ?

A

prevent frozen shoulder ( its tights not able to move, muscles get short )

183
Q

compression garment on lymphedema i not the same as wrapping a tenser

A

well no shat bruh

184
Q

what is leukemia?

A

malignant disease that affects bone marow, lymph system, spleen

185
Q

leukemia : the cancer cells/dysfunctional accumulate in where?

A

bone marow

186
Q

true or false. in leukemia there is no room for good cells.

A

true

187
Q

IF U HEAR BLAST - this what ?

A

bad cells

188
Q

immature white blood cells are good or bad

A

bad

189
Q

what are the subtypes of leukemia ?

A

AML , ALL, CML CLL

acute, chronic, myelogenous, lymphocytic

190
Q

what does this mean : AML , ALL, CML CLL

A

acute lymphoblastic leukemia (ALL) acute myeloid leukemia (AML) chronic lymphocytic leukemia (CLL) chronic myeloid leukemia (CML)

191
Q

what does leukemia results in :

A

thrombocytopenia, leukocytopenia, anemia- often hospitlization

192
Q

define if these are result from leukemia?

Frequent bloodwork, blood product transfusion
* Potential: splenomegaly, hepatomegaly, lymphadenopathy, bone pain, meningeal irritation)

A

yes

193
Q

bone marrow aspirate and biopsy determine what

A

determine subtype of leukemia and treatment protocol

194
Q

how does bone marow aspirate and biopsy ?

A

take some blood and look at white blood cells
- bone marrow aspirate ( done in the ileic crest and get some bone marrow and send to the lab )

195
Q

how is bone marrow aspirate and biopsy done?

A

done with mild sedative and mild cream

for kids
- continously sedared (

196
Q

leukemia :treatment specific protocol

A

may admit to hospital = aggressive radiation

197
Q

what undergoes aggressive chemo and radiaition in terms of sepcific protocl in leukemia

Induction Stage: Goal is remission (70% pts achieve remission)
* destroy leukemic cells in tissues, blood & bone marrow. Can cause critical complications (transfer to MICU at HSC or PICU at Childrens)
* Unit with air filtration (double doors)
* *Ng care focuses on:
* managing neutropenia, thrombocytopenia, anemia
* prevent/tx infection (follow protocols – surveillance swabs, culture, CXR, antibx)
* support systems (may need TPN, O2, IV fluid, protect kidney function) – assess for infection

define if these are true

A

true

198
Q

what is consolidation phase during leukemia treatment

A

mor chemo kill any remaining leukemic cells

199
Q

what is a maintenance phase during leukemia treatment with specific protocl

A

treatment with lower doses every 3-4 weeks for prolonged time

200
Q

temp every 4 hours
suveillance swab
if they do get an infection - swabbing them right away
in terms of someone who has leukemia and getting specific protocl

A

yes this is true

201
Q

leukemia : treatment what is a possibel treatment ?

A

bone marrow transplant where stem cells are transfused

202
Q

true or false. chemo and radiation in high doses prior is possible in leukemia treatment

A

yes this is true

203
Q

leukemia : treatment

infuse stem cells & wait for body to respond and develop immune system. Pt is what ?

A

pancytopenic

204
Q

what is recommended for leukemia patients who are under treatment

A

strict reverse isolation

205
Q

define if these are true amongs leukemia : when in treatments

  • Standing orders if pt has temp
  • Give blood products until pts body can make own
A

yes this is true

206
Q

what do we have to do before there marrows starts to works and transplants happens q

A

reverse isolation and keep them alive no shat

H & Illness 4: A & C illness (20 decks)

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