Haematology And Oncology

Question 1

Iron deficiency anemia

Answer 1

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

Question 2

Iron deficiency anemia assessment

Answer 2

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)

Question 3

Aplastic anemia 

Answer 3

Deficiency of circulating Erythrocytes due to suppression of bone marrow cells (congenital/radiation/toxins/viral and bacterial infection).

Question 4

Aplastic anemia assessment interventions

Answer 4

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

Question 5

polycythemia vera

Answer 5

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.

Question 6

oncology

Answer 6

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.

Question 7

Leukemia

Answer 7

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.

Question 8

What are the types of leukemia.

Answer 8

Acute lymphocytic leukemia (ALL),
Acute myelogenius leukemia(AML),
chronic lymphocytic leukemia(CLL),
chronic myelogenous leukemia(CML).

Question 9

Symptoms of leukemia

Answer 9

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.


Question 10

integumentary system: Skin cancer how to identify

Answer 10

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

Question 11

Poison ivy and poison oak

Answer 11

contact dermatitis: cleanse the skin of plant oil immediately(Uroshil)
this plant touch remove the clothes, and contact HCP

Question 12

Psoriasis

Answer 12

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.

Question 13

Eczema (Atopic dermatitis)

Answer 13

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

Question 14

Impetigo

Answer 14

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.

Question 15

Impetigore interventions 

Answer 15

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

Question 16

Herpeszoster (Shingles)

Answer 16

Reactivation of varicella zoster virus

A viral culture of the lesion provides the definitive to diagnosis: contact precautions

Question 17

Psychology therapy techniques therapeutic nurse

Answer 17

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.

Question 18

Therapeutic communication and children

Answer 18

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

Question 19

older adult client

Answer 19

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.

Question 20

effective skills and techniques

Answer 20

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.

Question 21

Clarifying techniques 

Answer 21

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.

Question 22

Mental health nursing interventions

Answer 22

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.

Question 23

Nursing interventions health promotional self-care activities

Answer 23

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

Question 24

Cognitive behavioral therapy

Answer 24

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

Question 25

Benzodiazepine 

Answer 25

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).


Question 26

Adverse effects for benzodiazepine

Answer 26

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.