Exam 1 Flashcards
What are Nursing Interventions for a neutropenic patient?
- Isolation Precautions
- Strict Hand hygiene
- No children (screen visitors)
- Monitor for a/s of infection (fever 100.4F or >)
- Avoid uncooked foods
- No fresh flowers or plants
- Good oral hygiene
Can a neutropenic patient consume a soft boiled egg?
NO!!!
- a soft boiled egg is not fully cooked.
What is the major difference between a benign and malignant neoplasms?
The ability of malignant tumor cells to invade and metastasize
What do you do if a patient’s WBC count on chemotherapy is too low?
STOP CHEMO!!!
What CBC value is a priority in a client on chemotherapy?
WBC Count
A patient on chemotherapy is experiencing nausea. What can be done to help relieve this side effect?
- Give client ondansetron med
- Patient should eat cold/room temperature foods instead of hot
What are some higher calorie intake methods?
- substituting water for milk in a recipe
- rubbing an egg wash on a piece of toast, etc
What causes a cancer patient on chemotherapy to lose so much weight?
Nausea and Vomiting, diarrhea, muscositis
Taking the med ondansetron can help relieve nausea and vomiting. How should this med be taken?
Take 1 hour before chemo, around the clock
A client is about to start chemo and that form of therapy comes with hair loss. How should you prepare the client?
Let the patient know BEFORE they start chemo
What is an intervention used for a client on chemo experiencing fatigue?
Walking
A patient on chemo is experiencing weight loss. What intervention can be done?
High calorie and protein diet
Muscositis is a side effect of chemo. How can a patient manage this inflammation of their mouth/tongue?
Rinse mouth, Avoid alcohol mouthwash, use only water
Interventions for a patient on chemo experiencing diarrhea can be…
- Antidiarrheal meds
- Avoid roughage, fries and fatty foods
What are some lifestyle habits to help reduce risk of Cancer?
- Avoid cigarette smoke and excessive sun exposure
- Limit alcohol use to 1 drink a day for women and 2 a day for men
- Exercise 30min, 5 days a week
- Maintain healthy weight, rest, reduce stress
- Have regular health exams (be familiar with family history)
What are the side effects of Immunotherapy?
- Flulike symptoms (fever, sore throat, headache, runny nose, cough,chills, skin flushing, etc)
- Anorexia/weight loss
- Fatigue
- N/V diarrhea
- photosensitivity
A client is undergoing immunotherapy and is experiencing a variety of side effects. What side effect poses a bigger emergency?
Fever!!!
- so check temperature
Are patients undergoing External Radiation radioactive?
NO. They are NOT radioactive.
- so they can go out and be around people
External beam radiation can cause side effects based on the location it is used on. What is the most common?
Fatigue and skin reactions (desquamation)
A client undergoing external radiation is experiencing some skin reactions. What are interventions that can be done?
Aloe Vera, Aquaphor and no perfumes
What radiation therapy cause a patient to be radioactive?
Internal radiation (using an implant)
- so, limit time near patient, use shielding, wear film badge
What is a common symptom of the graft-vs-host disease in a client undergoing HSCT?
rash on palms and on soles.
-diarrhea and infections also
What are some nonpharmacologic interventions for cancer pain?
Relaxation therapy and imagery
What is the single greatest barrier to effective cancer pain management?
Inadequate pain assessment
Patients with a first degree relative history of cancer follows a different protocol.
True
False
TRUE!!!!
Cancer survivors continue to increase . But everyone should be aware of the late and long term effects of cancer such as….
Secondary cancer, cognitive changes, cardiovascular/sexual dysfunction, psychosocial effects
What are the manifestations of Anemia?
- Fatigue/weakness
- Dyspnea
- Dizziness
- Palpitations
- Chest pain
- Pallor
What are nursing interventions regarding physical activity for a client with Anemia?
- Alternate rest and activity
- Maximize O2 supply for vital function
- Assess respiratory response
What do you expect the hemoglobin values to look like on a patient with Anemia?
Low < 6.0
High > 20.0
What are some iron-rich foods to recommend a patient with iron deficiency anemia??
Red meat, poultry, salmon, grains, leafy greens, shellfish, egg yolks, cooked spinach, green peas, dried fruits, legumes, brussels sprouts, and broccoli
What inhibits the absorption of iron??
Calcium
Should a patient take iron supplements on an empty stomach or with meals?
Best absorbed on an empty stomach
What are common iron deficiency anemia manifestations??
Pallor, glossitis, cheilitis
-including all other anemia symptoms.
What side effects of taking an iron supplement need to be reported to a provider?
Constipation and green/black stools
Taking iron supplements through a straw can decrease the side effect of…
Teeth staining
What component is crucial in order for patients to absorb Vitamin B12?
Intrinsic Factor (a glycoprotein)
Dietary recommendations for people with Folic acid deficiency??
Broccoli, pinto beans, soybeans, bananas, tomatoes
What types of patients may end up with pernicious anemia?
- Patients that have had any type of surgery that reduces the stomach lining/size
- Patients with alcoholism
- Strict Vegetarians
- Smokers
Treatment for pernicious anemia…
- IM injections
- oral supplements
- diet (lean red meat, chicken, fish, milk, dairy, eggs, etc)
Folic acid is important for women…
In childbearing age to prevent defects in developing fetus
At what platelet count would you watch a patient for spontaneous bleeding?
If platelet count is lower than 20,000 mm3
What are clinical manifestations of thrombocytopenia?
- Often asymptomatic
- common mucosal or cutaneous bleeding (petechiae, purpura, ecchymoses)
- Cerebral hemorrhage leading to stroke like symptoms
What type of bleeding due to thrombocytopenia can be difficult to detect?
Neurological
- ACT QUICKLY if confusion, irritability, drooping face, inability to talk/gibberish
What are ways we can prevent or control hemorrhage?
- soft bristle toothbrush
- electric razor
- avoid IM injections
-if subq injection unavailable, use small gauge needles and apply direct pressure or ice packs after!!!
-also discourage use of aspirin, OTC meds
Nursing interventions for a patient with multiple myeloma?
- pain control
- adequate hydration
- ambulating and weight bearing
What does the calcium level in a patient with multiple myeloma look like?
Elevated calcium levels (which can cause constipation)
What complication can arise from a patient with changes in calcium levels?
Constipation, renal and neurological issues, increased thirst, urination, bone and abdominal pain, n/v, anorexia
What type of anemia causes a decrease in all blood cell types?
Aplastic Anemia
Acute lymphocytic leukemia looks like…
Bleeding, infection, lymphadenopathy, fever, bone pain, CNS effects?
Chronic lymphocytic leukemia looks like…
Lymphadenopathy, hepatomegaly, splenomegaly
- typically affects adults greater than 65
What does chronic myelogenous leukemia look like?
Extreme tiredness, weight loss, fever, night sweats, pain
Hodgkin lymphoma is a rare type of lymphoma. What are some symptoms?
Fever, night sweats, pruritus, hepatosplenomegaly, weight loss
What are some clinical manifestations of Non-Hodgkins lymphoma? (More common type)
Lymph node enlargement (can wax and wane), symptoms depend on where disease is present
Acute myelogenous leukemia looks like…
Spontaneous bleeding, petechiae, ecchymoses, CNS effects, anemia symptoms
