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Med Surg I - Exam 3 > Neoplasms > Flashcards

Neoplasms Flashcards

1
Q

A patient with ACS (acute coronary syndrome) is being treated with a heparin infusion. What diagnostic finding suggests to the nurse that the treatment is effective?

a.) The patient’s PT is within the reference range
b.) Arterial blood gas sampling is positive for the presence of factor VIII
c.) The patient’s platelet level is below 100,000/mm3
d.) The patient’s activated partial thromboplastin time (aPTT) is 1.5 to 2.5 times the control value

A

d.) The patient’s activated partial thromboplastin time (aPTT) is 1.5 to 2.5 times the control value

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2
Q

What medications potentially alter platelet function? (Select all that apply)

a.) Antihypertensives
b.) Penicillins
c.) Sulfa-containing medications
d.) Aspirin-based drugs
e.) NSAIDs

A

a.) Antihypertensives
b.) Penicillins
c.) Sulfa-containing medications
d.) Aspirin-based drugs
e.) NSAIDs

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3
Q

A patient with hemophilia A has been brought to the ED after being involved in a MVA resulting in the fracture of his femur & internal bleeding. Rapid assessment has identified the source of bleeding & that the patient is current stable (VSS). What should the nurse anticipate next?

a.) Position the patient prone to minimize bleeding
b.) Establish IV access for administration of Vitamin K
c.) Prepare for administration of factor VIII
d.) Administer normal saline IV to increase circulating volume

A

c.) Prepare for administration of factor VIII

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4
Q

The patient is receiving a continuosu IV infusion of heparin. Based on the most recent lab data:
* PT = 13.2 (control 12.1)
* INR = 1.3
* aPTT = 72 (control = 39)

Which action should the nurse implement?

a.) Continue to monitor the infusion
b.) Prepare to administer protamine sulfate
c.) Have the laboratory reconfirm the results
d.) Assess the patient for bleeding

A

a.) Continue to monitor the infusion

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5
Q

The patient diagnosed with Type 2 DM is scheduled for bowel resection in the morning. Which medication should the nurse question administering to the patient?

a.) Ticlopidine (Ticlid), a platelet aggregate inhibitor
b.) Ticarcillin (Timentin), an extended spectrum antibiotic
c.) Pioglitazone (Actos), a thiazolidinedione
d.) Bisacodyl (Ducolax), a cathartic laxative

A

a.) Ticlopidine (Ticlid), a platelet aggregate inhibitor

Any medication that will prolong bleeding, as a platelet aggregate inhibitor does, should not be administered to the patient at least 2-3 days before surgery

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6
Q

Acute Myeloid Leukemia (AML)

  • What is it?
  • It is the most common type of what?
  • What is the treatment?

KNOW THIS (IN RED)!!!

A
  • It is a defect in stem cells that differentiate into all myeloid cells (monocytes, granulocytes, erythrocytes, & platelets)

Most common type of non-lymphocytic leukemia

  • Treatment = aggressive chemotherapy - induction therapy, BMT, or PBSCT
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7
Q

What is the treatment for acute myeloid leukemia (AML)?

KNOW THIS (IN RED)!!!

A

Aggressive Chemotherapy

  • Induction therapy
  • BMT or PBSCT
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8
Q

Signs & Symptoms of Acute Myeloid Leukemia

A
  • Increased risk of infection (s/s of infection are more subtle)
  • Bleeding
  • Bone pain
  • Mouth sores
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9
Q

What is acute myeloid leukemia?

A

Defect in the stem cells that differentiate into all myeloid cells (monocytes, granulocytes, erythrocytes, & platelets)

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10
Q

What is Chronic Myeloid Leukemia (CML) & what is the cause?

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A

Mutation in myeloid stem cells due to mutation in philadelphia chromosome

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11
Q

What is the life expectancy of patients with Chronic Myeloid Leukemia (CML)?

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A

3 - 5 years

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12
Q

What are manifestations / signs & symptoms of Chronic Myeloid Leukemia (CML)?

KNOW THIS (IN RED)!!!

A

May be asymptomatic initially

  • Malaise
  • Anorexia / Weight loss
  • Confusion
  • Shortness of breath caused by leukostasis
  • Enlarged, tender spleen
  • Enlarged liver
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13
Q

Chronic Myeloid Leukemia

1.) What is the cause of CML?

2.) What is the life expectancy of patients with CML?

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A

1.) Cause = inheritance of Philedalphia Chromosome

2.) Life Expectancy = 3-5 years

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14
Q

What is Acute Lymphocytic Leukemia (ALL)?

A

Uncontrolled proliferation of immature cells from lymphoid tissue

  • issue in bone marrow leading to uncontrolled proliferation of immature cells (leukocytes are immature & don’t work correctly)
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15
Q

Manifestations / Signs & Symptoms of Acute Lymphocytic Leukemia (ALL)

KNOW THIS (IN RED)!!!

A
  • Bone, liver, & spleen pain
  • Meningeal involvement like headaches, nuchal rigidity, photophobia, seizures
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16
Q

What age group is most likely to receive an Acute Lymphocytic Leukemia (ALL) diagnosis?

KNOW THIS (IN RED)!!!

A

Under age of 6

17
Q

What are the 2 main risks associated with Acute Myeloid Leukemia (AML), Chronic Myeloid Leukemia (CML), & Acute Lymphocytic Leukemia (ALL)?

KNOW THIS (IN RED)!!!

A
  • Increased risk of infection
  • Increased risk for bleeding

Check labs: ANC, hematocrit, cultures, platelets, leukocyte count

18
Q

Major Nursing Goals when treating patients with Leukemia (AML, CML, ALL)

KNOW THIS (IN RED)!!!

A
  • Absence of complications & pain
  • Attain & maintain adequate nutrition
  • Activity tolerance
  • Ability for self-care
  • Ability to cope with diagnosis & understand prognosis
  • Positive body image
  • Understanding of the disease process & its treatment
19
Q

What is the cause of Hodgkin Disease?

KNOW THIS (IN RED)!!!

A

Reed-Sternberg Cells

20
Q

What is the cure rate of Hodgkin Disease like?

KNOW THIS (IN RED)!!!

A

Excellent cure rate

21
Q

Signs & Symptoms associated with Hodgkin Disease

KNOW THIS (IN RED)!!!

A
  • Painless, enlarged lymph nodes
  • Pruritus
  • fever
  • weight loss
  • sweats
22
Q

What is the treatment for Hodgkin Lymphoma?

KNOW THIS (IN RED)!!!

A

Chemotherapy, Radiation, or Both

  • Treatment is determined by the stage of the disease
23
Q

Hodgkin Disease

1.) What is the cause?
2.) What is the cure rate like?
3.) What is the treatment?

KNOW THIS (IN RED)!!!

A

1.) Due to Reed-Sternberg Cells
2.) Excellent Cure Rate
3.) Treatment = chemotherapy, radiation, or both

24
Q

What is the most common age group diagnosed with Non-Hodkin Lymphoma?

KNOW THIS (IN RED)!!!

A

50 - 60 years old
* incidence increases with age

25
Q

What is the treatment for Non-Hodgkin Lymphoma?

KNOW THIS (IN RED)!!!

A

Inferferon, Chemotherapy, or Radiation Therapy

  • determined by type & stage of disease
26
Q

What is Multiple Myeloma?

A

Cancer of plasma cells in the bone marrow that causes bone marrow destruction

27
Q

Multiple Myeloma

1.) What is the median survival rate?
2.) What are the most common signs & symptoms?
3.) What is the treatment?

KNOW THIS (IN RED)!!!

A

1.) Median Survival = 2.5 - 5 years

2.) S/S = bone pain, fractures, & hyperkalemia (due to breakdown of the bone)

3.) Tx = chemotherapy, corticosteroids, radiation therapy, & bisphosphonates

No Cure

28
Q

What is the median survival rate for patients with Multiple Myeloma?

A

2.5 - 5 years

29
Q

What are the most common signs & symptoms of Multiple Myeloma?

KNOW THIS (IN RED)!!!

A
  • Bone pain
  • Hyperkalemia (due to breakdown of bone)
  • Fractures
30
Q

What is the treatment for Multiple Myeloma?

KNOW THIS (IN RED)!!!

A
  • Chemotherapy
  • Corticosteroids
  • Radiation
  • Bisphosphonates

  • No Cure
31
Q

A nurse is caring for a patient who has a diagnosis of acute leukemia. What assessment most directly addresses the most common cause of death among patients with leukemia?

a.) Monitor nutritional status
b.) Monitor electrolyte levels
c.) Monitor for infection
d.) Monitor liver function

A

c.) Monitor for infection

32
Q

A patient with leukemia has developed stomatitis & is experiencing a nutritional deficit. An oral anesthetic has been prescribed. What health education should the nurse provide the patient?

a.) Chew with care to avoid inadvertently biting the tongue
b.) Use the oral anesthetic one hour prior to meals
c.) Brush teeth before & after eating
d.) Swallow slowly & deliberately

Stomatitis = inflammation & redness of oral mucosa

A

a.) Chew with care to avoid inadvertently biting the tongue

Med Surg I - Exam 3 (17 decks)

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