Exam 2 - Multiple Myeloma, Blood Transfusions, and Lymphomas

Question 1

Assessment findings for multiple myeloma

Answer 1

Normally affects older people

Most common manifestation - rib pain in the back (bone pain)

Question 2

Most common complication of multiple myeloma

Answer 2

Spontaneous bone fracture

Question 3

What should you teach pts with multiple myeloma?

Answer 3

Do not lift more than 10lb

May need a back brace

Question 4

Another complication of multiple myeloma is:

Answer 4

Hypercalcemia

Question 5

Main treatment of hypercalcemia

Answer 5

Hydration (3 L a day)

Question 6

Nursing considerations for safe transfusion of blood products

Answer 6

Need informed consent
Blood needs to be checked by another RN
Stay with pt for 15 min after to check fo ranaphylaxis

Question 7

What is the s/sx of anaphylaxis with blood transfusions?

Answer 7

c/o chest pain, development of hives

Question 8

Priority action for anaphylaxis with blood transfusions?

Answer 8

Stop the infusion but do not take the IV out because it is still needed

Question 9

What is the ONLY fluid you can run in tandem with a blood product and why is it used?

Answer 9

Normal saline - run it with blood because otherwise it can clot

Question 10

What is the most common manifestation of Hodgkin’s disease?

Answer 10

Asymmetric, painless enlarged lymph node

Question 11

Other manifestations of Hodgkin’s

Answer 11

Pruritis, B symptoms - fever, sweats, weight loss

Question 12

Lymphoid tissues become infiltrated with malignant cells, spread is unpredictable and localized disease is rare
Incidence increases with age

Answer 12

Non-Hodgkin’s

Question 13

Complication of chemotherapy for lymphoma

Answer 13

Myelosuppression

Question 14

Complication of radiation for lymphoma

Answer 14

Fragile, irritated skin

May have breakdown of mucous membranes and ulcers in mouth, nose, skin

Question 15

Stage of lymphoma; involvement of a single lymph node region or lymphoid structure (spleen, thymus, lymphoid tonsillar tissue)

Answer 15

Stage I

Question 16

Stage of lymphoma; involvement of two or more lymph node regions on the same side of diaphragm

Answer 16

Stage II

Question 17

Stage of lymphoma; involvement of lymph node regions or structure on both sides of diaphragm

Answer 17

Stage III

Question 18

Stage of lymphoma; limited to upper abdomen (spleen, splenic, celiac, or portal nodes)

Answer 18

Stage III - 1

Question 19

Stage of lymphoma; involvement of lower abd nodes (para-aortic, iliac, or mesenteric)

Answer 19

Stage III - 2

Question 20

Stage of lymphoma; involvement of an extranodal site (non proximal or contiguous with an involved node) such as the liver, lung or pleura, bone or bone marrow, or skin

Answer 20

Stage IV

Question 21

Lymphoma - no systemic symptoms

Answer 21

A

Question 22

Lymphoma - systemic symptoms - fever, night sweats, and weight loss

Answer 22

B

Question 23

How is Stage I or II treated?

Answer 23

2-4 months of chemo followed by radiation to specific involved areas

Question 24

How is Stage III or IV treated?

Answer 24

Combination chemo with ABVD is often standard with B symptoms