Haematology And Oncology Flashcards
Iron deficiency anemia
normally iron formed in the intestine,-converted to ferritin and stored in the liver, spleen, bone marrow.
Duodenum-most iron absorption happens here.
In this anemia, Iron stores are depleted
Iron deficiency anemia assessment
Pallor;weakness;fatigue;irritability, SOB, dizziness, Brittle spoon like nails, Cheilosis(cracks in corner of mouth)
Interventions:oral iron supplements – give with orange juice/vitamin C.
Antacids interferes with absorption.
Liquid iron preparations stain teeth; should be given through a straw.rinse mouth thoroughly
Instruct to take iron supplement empty stomach (or between meals) for the delay absorption
Stool-greenish tarry color. constipation common (fluid and fiber).
Parental iron supplements (Iron dextran)are only given for severe anemia (z track method)
Aplastic anemia 
Deficiency of circulating Erythrocytes due to suppression of bone marrow cells (congenital/radiation/toxins/viral and bacterial infection).
Aplastic anemia assessment interventions
Assessment: pancytopenia;Petechiae; purpura;pallor, weakness, fatigue,
tachycardia bleeding from gums, nose.
interventions:prepare for bone marrow transplant, if planned,
Riverse isolation, limit visitors, bleeding precautions.
Frequent rest periods, handwashing.
Administer immunosuppressive medications, blood
educate about wearing medic Alert bracelet
polycythemia vera
Chronic disorder after of the bone marrow:: too many red blood cells,white cells ,and platelets are produced.
Risk of developing lead closed due to increased blood volume,and viscosity.
Major issues: stroke, pulmonary edema, DVT.
nursing care:Elevate the legs and feet when sitting, wear support stockings,
reports signs of thrombosis(example swelling and tenderness in the leg).
Adequate fluid intake during exercise and hot weather -to reduce fluid loss and decrease viscosity. Periodic phlebotomy remove excess blood (the removal of 300 to 500 ML milliliters)
phlebotomy every other day until goal hematocrit is reached.
oncology
Factors that influence cancer development: environmental , Dietary,genetic preposition, age, immune function,
explore to certain virus and a bacteria.
Liver Epstein berr has been linked to an increased risk of lymphocancer can develop after many years of infection with hepatitis B and hepatitis C.
Human papilloma virus(HPV) infection is the main cause of cervical cancer.
HIV increases the risk of lymphoma and Kaposi’s sarcoma(grow in the skin)
Helicobacter pylori may increase the risk of stomach cancer and lymphoma of the stomach lining.
Leukemia
Leukemia are cancer of white blood cells or of cells that develop into white blood cells, these white blood cells are not function,and destroy bone marrow.
Overgrowth of leukemia cells prevent growth of other blood components. (Platelets, erythrocytes, mature leukocytes.
Infection: major cause of death in an immuno suppressed client.
What are the types of leukemia.
Acute lymphocytic leukemia (ALL),
Acute myelogenius leukemia(AML),
chronic lymphocytic leukemia(CLL),
chronic myelogenous leukemia(CML).
Symptoms of leukemia
Psychological-Fatigue (decreased Rbcs), loss of appetite-anemia, natural tendency.
Lymph nodes- infections, swelling.
spleen and/or liver enlargement-organ problem, process immature clear Blass cell.
skin-night sweats,easy bleeding, purpleish patches(petechiae, chemosis, bruising , purpura)
systemic-weight loss, fever, frequent infection rate-(sore throat, infections).
Lungs- easy shortness of breath. Muscular weakness,
bones are joints-pain or tenderness.

integumentary system: Skin cancer how to identify
ABCDE: A- a symmetry both sides are not equal.
B-border irregular shape, C-color:color, shape,size, yellow ,brown,red.
D- diameter,-if more than 6mm considered carcinoma
E-evolution:color,size,shape and bleeding,bruises or injuries
Poison ivy and poison oak
contact dermatitis: cleanse the skin of plant oil immediately(Uroshil)
this plant touch remove the clothes, and contact HCP
Psoriasis
Skin disorder that is characterized by scaly, dermal patches (silvery)and caused by and lower an over production of keratin.
an auto immune disorder and exacerbation and remission.
Can also effect the joints,causing arthritis-type changes in pain.
Treatments :-meds -antihistamines, antibiotics, steroids,chemo meds, phototherapy
Skin care: client not to scratch affected areas,keep skin lubricated to minimize itching, Patty dry(No rubbing)
Play emollient lotion immediately after bath. Use antibacterial soaps for handwashing lanolin, lacto calamine.antibacterial soaps
Avoid wool constrictive (itching,trap sweats)cotton clothes are OK ,don’t cover it -that may sweat and itchy ,nail short.
Eczema (Atopic dermatitis)
Inflammatory skin disorder, unknown cause
Mains/ symptoms:pruritus, erythema and dry skin.
Triggers : stress, humidity, allergens, irritant (soap, detergent, wool).
Red raised lesions start from check,spread to forehead, spread to forehead, arms and legs.
identify and control triggers, keeps skin dry and lubricated-tepid bath, Patty-dry, to-apply emollient lotions
Infants -keep fingernails clean and shirt, place cotton gloves or socks to prevent scratching
Impetigo
Highly contagious bacterial infection in skin
honey color crest, contact precaution: gloves, gown if they cough wear a mask.
Caused by beta hemolytic streptococci, staphylococci and/or both
assessment: Honey-crest lesions; pruritus;burning; second lymph node involvement.
Impetigore interventions 
Contact isolation, teach to prevent the spread of infection.
inform of need to use separate towels ,linens, dishes.
All linens,clothes of infected clients need to be washed with the detergent and hot water separated from others in the family.
Administer topical and oral antibiotics as prescribed -scabs or crusts must be carefully remove for the antibiotic ointment to be effective.
apply warm compress to lesions 2 to 3 times per day as prescribed
Herpeszoster (Shingles)
Reactivation of varicella zoster virus
A viral culture of the lesion provides the definitive to diagnosis: contact precautions
Psychology therapy techniques therapeutic nurse
Constantly focus, ideas, experiences and feelings.
Identify and explore the client needs and problems
discusse problems with the client’s alternate with the client.
Help to develop strengths and new coping skills.
Encourage positive behavior change in the client
Assist the client develop a sense of autonomy and self-reliance.
portray genuineness, empathy, and positive regard toward the client.
The nurse practice empathy by remaining non-judge mental and attempting to understand the client actions and feelings.
The nurse differs from sympathy, in which in which the nurse allows herself to feel the way the client does and in nontherapeutic
client centered not social or reciprocal.
Therapeutic communication and children
Use simple and straightforward language.
be aware of own nonverbal messages, as children or sensitivity to nonverbal communication. Enhance communication by being at the Child’ s eye level
incorporate play in interactions
older adult client
Recognize that the client may require amplification (volume up)
minimize distractions, (turn off Tv)And face the client when speaking.
Allow plenty of time for the client to respond.
When impaired communication is assessed assist, but input from caregivers or family to determine the extent of the deficits and how best to communicate.
effective skills and techniques
Silence: Allow time for meaningful reflection
Active listening call Allam the nurse is able to hear, observe, understand what the client communicates and to provide feedback. Open ended questions: this technique facilitates spontaneous responses and interactive discussions.
Showing acceptance send recognition
focusing:helps clients to concentrate on what is important.
asking questions
Summarizing Allam emphasizes important points and reviews what has been discussed.
Clarifying techniques 
Restarting- use the client Exact words
reflecting – direct the focus back to the client in order for the client to examine his feelings
Paraphrasing -restart the clients feelings and thoughts for the client to confirm what has been communicated
Exploring-the nurse to gather more information regarding important to topics mentioned by the client.
Mental health nursing interventions
Counseling:using therapeutic nursing skills
assisting with problem-solving, crisis intervention. Stress management.
Millieu therapy: Management of total environmental of the mental health unit to provide the least amount of stress:: patient could cope adaptively, interact more effectively, and appropriately, and strengthen relationship skills.
Orienting the client to the physical setting orientation.
Identifying rules and boundaries of the set settings.
Ensuring a safe environmental for the client.
Assisting the client to participate in appropriate activities.
Nursing interventions health promotional self-care activities
Promotion self care activities:offering assistance with the self-care task.
Allowing time for the client to complete self-care tasks.
Setting incentives to promote clients self-care.
Health promotions and maintenance:assisting the client with the cessation of smoking
monitoring other health conditions
psychobiological interventions: administer prescribed medication.
Providing teaching to help client family about medication.
Monitoring for adverse effects and effectiveness of pharmacological therapy
Cognitive and behavioral therapy (thinking higher thought process behavior according to therapy
Cognitive behavioral therapy
CBT5 components:1)education: about the client specific disorder.
2)Self observation and monitoring: the client learns how to Monitor anxiety.
identify triggers,and assist the severity
physical control strategies:deep breathing and muscle relaxation exercises.
Cognitive restructuring-learning new ways to reframe thinking pattern, challenging negative thoughts
behavioral strategies -focusing on situation that causes anxiety and are practicing
new coping behavior, desensitization to anxiety -provoking situation or events
Benzodiazepine 
Sedative hypnotic anxiolytic-benzodiazepine
Benzodiazepines are generally use a short term-dependence
Dizepam is contraindicated in clients who have sleep apnea,respiratory depression,and/or glaucoma .
avoid abrupt discontinuation-dapper the dose. give with food to reduce G.I. discomfort. benzodiazepine toxicity-assessment, IV gastric, gastric lavage, administering flumazenil (to reverse the effect).

Adverse effects for benzodiazepine
CNS depression, (sedation,lightheadedness, ataxia decreased cognitive function).
2)Anterograde amnesia (difficulty recalling events that occur after dosing)
3). Acute toxicity,oral toxicity (drowsiness,lethargy,confusion)
I/v toxicity (may lead to respiratory depression, severe hypertension, or cardiac/respiratory arrest).
benzodiazepines for I’ve use include Diazepam (Valium),lorazepam (Ativan).
Paradoxical response (insomnia, excitation,euphoria, anxiety, rage).
Manifestations of withdrawal include anxiety insomnia, diaphoresis, tremors, lightheadedness.
