Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced Med/Surg > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

what is hypercalcemia?

A

it is found in cancers that metastasize to bone (ex. lung, breast, renal), but can be r/t paraneoplastic hormone production in lung and pancreatic cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

a patient presents with delirium, somnolence, muscle weakness, polyuria, bradycardia, nausea, and constipation. What oncological emergency is this?

A

Hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What should the nurse implicate for hypercalcemia?

A
  • monitor Ca, P, and renal fx
  • assess s/s of hypercalcemia
  • provide hydration and ordered meds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are expected medications for cancer related hypercalcemia?

A
  • Bisphosphonates
  • Denosumab
  • Calcitonin?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is spinal cord compression as an oncological emergency?

A

commonly found when there are tumors near the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A patient presents with pain, numbness, tingling, and motor weakness. What oncological emergency is happening?

A

Spinal cord compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a late sign of spinal cord compression?

A

autonomic dysfuction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Nursing implications for spinal cord compression

A
  • assess typical s/s of compression (pain/weakness, inability to distinguish hot and cold)
  • assess for constipation or incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some treatment options for spinal cord compression?

A
  • corticosteroids
  • radiation therapy
  • surgery
  • drug therapy (bisphosphonates are given to prevent bone breakdown)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is superior vena cava syndrome?

A

A tumor r tumor-involved lymph node compression of soft-walled SVC causes reduced return of blood flow to heart and venous congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A patient presents with dyspnea, venous congestion/edema of the upper body, visual disturbances, HA, altered mental status r/t cerebral edema, JVD, and prominent brachial and chest veins. What oncological emergency is this?

A

Superior vena cava syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Nursing implications for SVC syndrome?

A
  • assess s/s

* assess poor perfusion and decreased CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are signs that a patient have low CO?

A

confusion, cyanotic, hypotension and tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is SIADH?

A

This is commonly found in patients who have primary or metastatic brain or lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A patient presents with s/s of hyponatremia (mental status changes or seizures), HTN, effusions, diluted electrolytes r/t edema and a low hematocrit. What oncologic emergency is this patient experiencing?

A

SIADH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is expected treatment for SVC syndrome?

A
  • treatment of the cancer that causes it w/ chemo or radiation
  • drug therapy: corticosteroids or diuretics to get rid of the excess fluids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Nursing implications for SIADH?

A
  • assess s/s of FVO (HTN, hyponatremia, confusion, seizures, and coma)
  • restrict fluids and administer meds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is tumor lysis syndrome?

A

common is patients with rapidly proliferative tumors such as leukemia and lymphoma or therapy-sensitive tumors that respond quickly to treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A patient presents with electrolyte imbalances and renal dysfunction, hypocalcemia, hyperkalemia, acidosis causing heart block, tachycardia, and hyperphosphatemia. What oncological emergency is this patient experiencing?

A

tumor lysis syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Nursing implications of tumor lysis syndrome?

A
  • assess s/s of hypocalcemia, renal dysfunction

* assess EKG changes and hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are peaked T-waves indicative of?

A

hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are some s/s of hypocalcemia?

A

paresthesia, numbness of fingertips and perioral neuromuscular irritability and possible laryngeal contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does PUKEC stand for and what oncological emergency is it representative of?

A 
Tumor Lysis Syndrome
P- phosphorus
U- uric acid
K- K+
E- elevated
C- calcium decreased
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are causes of Iron-Deficiency Anemia?

A

poor intake, blood loss, absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What would cause absorption issues?

A

crohns, celiac, or meds that alter stomach acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

clinical manifestations of IDA?

*hint: remember LOW IRON

A 
L= lethargic
O= overexerted easily (SOB)
W= weird food cravings (aka pica)
I= inflammation of tongue
R= reduced hemoglobin
O= observe changes in RBC's
N= nails (koilonychias), neuro
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Patient teaching for IDA? Common SE of iron supplement?

*hint: EAT LOTS OF IRON

A
  • take iron with citrus juice
  • use Z-track for IM iron
  • use straw with oral iron
  • SE= stomach cramps, green/black stool, constipation/diarrhea
    E= egg yolks
    A= apricots
    T= tofu
    L=legumes, leafy greens, broccoli
    O= oysters
    T= tuna
    S= sardines, seeds
    O= pOtatoes
    F= fish
    I= iron fortified cereals
    R= red meat
    O= pOultry
    N= nuts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Causes of pernicious anemia (aka vitamin B-12 anemia)?

A

poor intake

* pernicious is a failure to absorb B-12, d/t lack of intrinsic factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Who typically has issue with B-12 intake?

A

vegetarians b/c b-12 only comes from animal meat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Clinical manifestations of b-12 anemia?

A

SOB, tachypnea, tachycardia, fatigue, neuro and psychiatric dysfunction

31
Q

diagnostic tests for IDA?

A

ferratin, TIBC, CBC, MCV

32
Q

diagnostic tests for b-12 anemia?

A

CBC, B12 serum assay level, methylmalonic acid (MMA), shillings test (only for pernicious)

33
Q

patient teaching for B12 anemia? What food can you find it in?

A

animal meat, seafood, egg, dairy?

34
Q

causes of folic acid anemia?

A

poor nutrition, chronic alcohol abuse, malabsorption syndromes, and meds that slow/prevent absorption

35
Q

Clinical manifestations for folic acid anemia?

A

same as B12, but w/out the neurologic sx’s, increased bleeding risk, mood changes, neural tube defects

36
Q

diagnostic tests for folic acid anemia?

A

RBC folate level

37
Q

what is the increased bleeding risk related to?

A

bone marrow damage

38
Q

What is the cause of aplastic anemia?

A

damage to the bone marrow= myelosuppression= pancytopenia

39
Q

what are some reasons for damage to the bone marrow?

A

chemo, radiation, exposure to chemical, infection

40
Q

This is the most common type of genetic hemolytic anemia

A

Glucose-6-Phosphate dehydrogenase

41
Q

what population does glucose-6-phosphate dehydrogenase effect the most?

A

African American Males

42
Q

what is the lifespan of normal and sickle RBCs?

A 
Normal= 120 days
sickle= 1520 days
43
Q

This anemia causes thick, viscous blood and decreases circulation. What type of anemia is this and what is the cause of it?

A

polycythemia vera; excess RBCs

44
Q

What is hemophilia and what are some possible treatments?

A

hemophilia is a genetic condition where the body most commonly lacks the coagulation factor VIII. This causes the person to bleed severely even with the slightest injury. Treatment often includes clotting factor injections or plasma.

45
Q

Risk factors for cancer?

A
  • carcinogen exposure
  • age
  • genetics
  • hormones
  • lifestyle
  • infectious disease
  • medications
  • nutrition
46
Q

Primary, secondary, and tertiary prevention of cancer

A

Primary: rx fx modification
> immunization
> chemoprevention
Secondary: screening and clinician assessment
Tertiary: tx and SE management of cancer or its treatment

47
Q

What are things that may lead to to think cancer?

*hint= think CAUTION

A 
C= change in bowel/bladder habits
A= a sore that doesn't heal
U= unusual bleeding/discharge
T= thickening/lump in breast or body
I= indigestion or difficulty swallowing
O= obvious change in wart or mole
N= nagging cough or hoarseness
48
Q

Cancer treatment goals

A
  1. cure
  2. prevent remission
  3. provide palliative care
49
Q

post-surgical treatment to consider for cancer

A
  • pain management
  • psychosocial support
  • infection prevention
  • No BP or needle sticks on affected limb after mastectomy
50
Q

types of radiation treatments

A
  • External= teletherapy
  • internal=brachytherapy-seeds
  • systemic-injection of radioactive solution
51
Q

Complications of radiation

A
  • inflammation
  • mucositis & xerostomia= ORAL CARE!!!
  • fatigue
  • thrombocytopenia= BLEEDING RISK!!!
  • fibrosis
  • immediate hazard to others d/t radioactive iodine
52
Q

safety measure to consider with radiation therapy

A
  • private room
  • sign on the door
  • wear dosimeter
  • visitors 30 min/day and 6ft apart
  • lead apron & container
  • follow policy
53
Q

goals of chemotherapy

A

cure/increase life time

54
Q

What does chemotherapy do and what unpleasant effects does it cause?

A
  • chemo interferes with cell division in rapidly dividing cells
    > therfore…. it damages skin, hair, intestinal tissues, and blood-forming cells
55
Q

What should you assess in a patient undergoing chemo?

A

cognition

56
Q

considerations for chemo administration

A
  • done with an RN w. education
  • chemo is a systemic treatment
  • wear eye, mask, gloves (double or chemo), and gown
57
Q

Chemo complications

A
  • extravasation- vesicants
58
Q

interventions for extravasation?

A
  • close monitoring
  • cool/warm compress
  • antidote
  • consultation
59
Q

Adverse effects of chemo?

A
  • n/v/d
  • peripheral neuropathy
  • alopecia/hemorrhagic cystitis
  • cardio/hepato/toxicity
  • hypersensitivity
  • capillary permeability syndrome
  • infertility
    clotting abnormalities
60
Q

neutropenic precautions

A
  • inspection, lung souds, oral assess, close IV inspection
  • low bacteria diet
  • no fresh flowers or plants
  • avoid raspberries and blackberries
61
Q

how often do you take VS on a patient with neutropenic precautions?

A

4-8 hrs

62
Q

Interventions for mucositis

A
  • swishing lidocaine
  • saline rinse
  • soft tooth brush
  • gentle flossing
  • gentle/bland diet
  • NO ALCOHOL BASED RINSES!
63
Q

normal RBC level

A

Male: 4.7-6.1
Female: 4.2-5.4

64
Q

normal hemoglobin

A

Male: 14-18
Female: 12-16

65
Q

normal hematocrit

A

Male: 42-52%
Female: 37-47%

66
Q

Normal WBC

A

5000-10000

67
Q

Normal platelet

A

150000-400000

68
Q

MCV: what does it tell us when it is high and low and what is the normal value?

A 
low= small RBC size
high= large RBC size
normal= 80-95 mm3
69
Q

MCH: what does it tell us when it is high and low and what is the normal value?

A 
low= lighter color
high= darker color
normal= 27-31 pg/cell
70
Q

What are quality care nursing implications for sickle cell disease?

A
  • administer O2
  • pain meds
  • aggressive IV/PO hydration
  • blood transfusions
  • antipyretics
  • provide emotional support
71
Q

what to teach about sickle cell disease?

A
  • avoid cold temperatures, tight clothes, high-altitudes, dehydration, overexertion
  • infection prevention
  • keep ADLs
    risk for crises w/ pregnancy
  • Fetal complications
  • genetic counseling
  • dental care
72
Q

Steps to take prior to transfusion therapy

A
  • verify order
  • obtain signed-consent
  • type/cross match
  • hx of reactions
  • 18-20 G IV
  • get blood from pharmacy
  • 2 RNs verify
  • prime tubing and inspect blood
  • only run with NS!!!
73
Q

Geriatric considerations for transfusion therapy

A
  • no larger than 19G
  • assess renal fx
  • newer blood products
  • assess q 15 min
  • administer over 2-4 hrs
74
Q

What different transfusion types are there and what are they for?

A
  • PRBC= iron deficiency or anemia
  • plasma= liver failure, severe infections, and serious burns, clotting factor deficiencies
  • cryoprecipitate (controls bleeding in people who don’t clot properly)
  • granulocyte= these are WBC that are able to phagocytize foreign substances; for neutropenic patients

Advanced Med/Surg (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions