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Med/Surg > Oncology > Flashcards

Oncology Flashcards

1
Q

Extravasation

A

The escape of blood or lymph from their proper vessels into surrounding tissues.

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2
Q

Vesicants

A

An agent that causes blistering.

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3
Q

Nadir

A

The point at which blood cell counts are at their lowest after a chemotherapy treatment.

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4
Q

thrombocytopenia

A

A blood disease characterized by an abnormally low number of platelets in the bloodstream

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5
Q

leukopenia

A

when the levels of WBCs in your blood are lower than average.

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6
Q

desquamation

A

The shedding of the outer layers of the skin

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7
Q

intrathecal

A
  1. within a sheath. 2. through the theca of the spinal cord into the subarachnoid space.
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8
Q

Uncontrolled cell growth

A

Cancer

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9
Q

2nd leading cause of death in the U.S.

A

Cancer

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10
Q

Causes of cancer

A

some genetic tendencies, some related to environmental expose, some related to infectious agents

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11
Q

Infectious agents that can cause cancer

A

human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Helicobacter pylori (H. pylori),

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12
Q

Cancer can be prevented through

A

behavioral changes, vaccination, or treatment of the infection.

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13
Q

A process that begins when an abnormal cell is created by the genetic mutation of a cell’s DNA

A

Cancer pathophysiology

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14
Q

Increased cell growth

A

proliferation

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15
Q

Cancer cells that don’t always multiply rapidly, but do increase & spread without cell “boundaries”

A

proliferation

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16
Q

Cells should grow into the mature type- if not they remain like immature or fetal cells…

A

differentiation

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17
Q

UN-LIKE the mature cell

A

undifferentiated

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18
Q

Pre-malignant or malignant

A

differentiation

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19
Q

Number 1 Carcinogen

A

Tobacco smoke

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20
Q

Environmental Carcinogens:

A

tobacco, exposure to occupational chemicals, asbestos, benzene

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21
Q

30% of cancer can be traced to

A

Smoking and 2nd hand smoke

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22
Q

Environmental Carcinogen drugs

A

pesticides

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23
Q

Environmental Carcinogens viruses

A

Epstein-Barr, HPV, h. pylori

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24
Q

Environmental Carcinogen: radiation

A

sun, treatment, radon, nuclear exposure

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25
Q

Potential causes of mutations from diet

A

eating too many animal proteins/fats, alcohol, and cured foods

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26
Q

Epstein-Barr is linked to

A

mononucleosis

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27
Q

Potential causes of mutation relating to immune response

A

Autoimmune disorders and medications

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28
Q

Potential causes of mutations in genetics

A

chromosome/genes (BRCA1 &2?)

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29
Q

TAA’s (proteins)

A

Tumor associated antigens on surface of cancer cells

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30
Q

lymphokines& Tumor Necrosis Factors=

A

CELL DEATH

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31
Q

cytotoxic B lymphocytes & Killer T cells kill cells with

A

TAA

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32
Q

7 Warning Signs: CAUTION

A

C hange in bowel/bladder
A sore does not heal
U nusual bleeding
T thickening or lump
I indigestion
O bvious change in wart
N agging cough

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33
Q

Change in bowel/bladder could indicate

A

Colon, prostate, or bladder cancer

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34
Q

A sore that does not heal could indicate

A

Leukemia or lymphoma

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35
Q

Unusual bleeding could indicate

A

Leukemia

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36
Q

Thickening or a lump could indicate

A

Breast cancer or lymphoma

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37
Q

Indigestion could indicate

A

Cancer of the GI tract

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38
Q

Obvious change in a wart could indicate

A

Skin cancer

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39
Q

A nagging cough could indicate

A

Lung cancer or lymphoma

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40
Q

Baseline breast screening is done at age

A

35

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41
Q

Breast screening is performed

A

mammo over 40y annually

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42
Q

Colon screening is performed

A

starting at age 45: colonoscopy every 10 years

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43
Q

occult blood is tested

A

yearly

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44
Q

Virtual colonography is performed

A

Every 5 years

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45
Q

Prostate exam is performed

A

PSA & digital exam is done annually starting at age 50

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46
Q

PSA

A

Prostate specific antigen

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47
Q

What is PSA?

A

PSA is a protein produced by the prostate gland

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48
Q

Pap smear is performed:

A

Every 3 years when over 21 yrs of age

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49
Q

Americans are too sedentary and their diet is too high in

A

saturated fats

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50
Q

Prevention education includes the dangers of

A

smoking and excessive alcohol use

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51
Q

Primary cancer health action

A

Prevent

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52
Q

Primary cancer promotions

A

Educate about risks
Diet & lifestyle changes
Cancer prevention programs

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53
Q

Secondary cancer health action

A

Find early

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54
Q

Secondary cancer health action

A

Identification of at risk groups
Cancer Screening

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55
Q

Classification of cancer:

from embryonic skin, gland, mucous membranes of resp. tract, GI & GU

A

Carcinomas

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56
Q

Known as “solid tumors”

A

Carcinomas

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57
Q

Classification of cancer:

connective tissue, muscle, bone, fat

A

Sarcomas

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58
Q

Classification of cancer:

hematopoietic system (bone marrow)

A

Lymphoma, leukemia, and Hodgkins/Non Hodgkins

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59
Q

Known as “liquid” or “blood” tumors

A

Lymphoma, leukemia, and Hodgkins/Non Hodgkins

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60
Q

Glandular tumors

A

adenocarcinomas

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61
Q

Tumors of the bone

A

Osteosarcoma

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62
Q

Grading and staging of tumors is determined by

A

A pathologist

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63
Q

pattern of growth in which cells lack normal characteristics and differ in shape and
organization with respect to their cells of origin; usually, anaplastic cells are malignant (Grade IV)

A

anaplasia

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64
Q

The presence of cells of an abnormal type within a tissue, which may signify a stage
preceding the development of cancer (grades I-III)

A

dysplasia

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65
Q

Grading by cell appearance:
I

A

slightly different (dysplagia)

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66
Q

Grading by cell appearance:
II

A

moderate dysplagia

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67
Q

Grading by cell appearance:
III

A

very abnormal -poor differentiation

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68
Q

Grading by cell appearance:
IV

A

Immature, fetal, not same as mature cell (anaplastic)

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69
Q

Grade IV is sometimes difficult to identify

A

Cell origin

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70
Q

cells or tissues that have lost their mature or specialized features

A

Anaplastic

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71
Q

How different is the cell?

Well differentiated

A

Similar

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72
Q

How different is the cell?

Moderately differentiated

A

Less similar

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73
Q

How different is the cell?

Extremely differentiated

A

Anaplastic

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74
Q

Stage 0

A

in situ

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75
Q

In situ

A

the earliest stage, non-invasive

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76
Q

Stage 1

A

local- in tissue of origin

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77
Q

Stage 2

A

limited, local

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78
Q

Stage 3

A

extensive, regional lymph node or tissue extent

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79
Q

Stage 4

A

metastasis

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80
Q

Staging:

present, not invading

A

stage 0

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81
Q

Staging:

In tissue of origin, potential for motion

A

Stage 1

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82
Q

Staging:

Great potential to spread

A

Stage 2

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83
Q

Staging:

extensive but no evidence of metastasis

A

Stage 3

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84
Q

Staging:

Travelled to different area of body

A

Stage 4

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85
Q

Grading scale used for prostate

A

Gleason scale

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86
Q

The lymph system can be an indicator of

A

where the tumor is

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87
Q

Tumor is sometimes washed towards

A

lymph nodes closest to origin

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88
Q

metastasis

A

cancer has spread to a different body part than where it started

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89
Q

Common symptoms of brain metastasis

A

Headaches, seizures, vertigo, vision problems

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90
Q

Common symptoms of respiratory metastasis

A

Cough, hemoptysis, dyspnea

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91
Q

Common symptoms of lymph node metastasis

A

lymphadenopathy

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92
Q

Common symptoms of liver metastasis

A

Hepatomegaly, jaundice

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93
Q

Common symptoms of skeletal metastasis

A

fractures, pain, spinal cord compression

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94
Q

CEA

A

carcinoembryonic antigen (associated with bowel cancer)

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95
Q

CA125

A

ovarian cancer indicator

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96
Q

Immature Cells

A

blast or stem cells

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97
Q

cells that look like “fetal” or immature cells can be found

A

in the blood with certain cancers

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98
Q

Diagnostic labs

A

CBC, WBC

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99
Q

diagnostic tests

A

Biopsy-
MRI
CAT
Endoscopy
Xray
PET scans

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100
Q

the 3 goals

A

CURE
CONTROL
PALLIATION

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101
Q

the 4 treatments

A

SURGERY
RADIATION
CHEMOTHERAPY
BIOLOGIC AGENTS

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102
Q

Types of cancer surgery

A

debulk, radical, supportive

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103
Q

Types of radiation

A

internal or external

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104
Q

Curative surgery

A

Completely removes all cancer/tumor

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105
Q

Type of surgery such as colostomy for obstruction, insert drainage tubes, PEG’s etc

A

Supportive (palliative)

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106
Q

Surgery for prevention

A

Prophylactic

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107
Q

If there is numbness, there may be ______ of the spine

A

compression

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108
Q

Lung and breast cancer can be found in the

A

brain

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109
Q

abnormal size or consistency of the lymph nodes

A

lymphadenopathy

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110
Q

Colon cancer will first travel to

A

Liver

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111
Q

Prostate and breast cancer will travel to

A

the bones

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112
Q

TNM

A

Tumor, Node, Metastasis

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113
Q

TNM Classification:
T

A

Tumor size

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114
Q

TNM Classification:
N

A

Lymph nodes involved

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115
Q

TNM Classification:
M

A

metastasis

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116
Q

Gold standard of cancer diagnostics

A

biopsy

117
Q

cells that look like “fetal” or immature cells can be found

A

in the blood with certain cancers

118
Q

diagnostic labs

A

CBC, WBC

119
Q

Abnormal PSA test could be benign but suspicious if

A

number drastically changes

120
Q

Tumor markers

A

Tumor specific antigens (CEA, PSA)

121
Q

Tumor specific antigens can be used to

A

diagnose or determine treatment success

122
Q

CEA can be used to determine

A

uterine or colon cancer

123
Q

PET

A

Positron emission tomography

124
Q

This test uses a safe injectable radioactive chemical called a radiotracer and a device called a _____ scanner.

A

PET scan uses a PET scanner

125
Q

Diagnostic test can be used all over body and can see organ function in real time

A

PET scan

126
Q

Non invasive 3D imagine diagnostic test

A

MRI

127
Q

Diagnostic test:
cross section x-ray of body

A

CAT scan

128
Q

Immature cells in blood are usually a sign of

A

Leukemia

129
Q

Diagnostic test done annually after remission

A

CAT scan

130
Q

Curing cancer can be difficult in people with

A

comorbidities

131
Q

Controlling side effects of tumor

A

Palliation

132
Q

Examples of palliation

A

pain control or colostomy for colon cancer

133
Q

Clear margins indicate

A

tumor was within surrounding tissue

134
Q

sometimes tumor is removed with

A

surrounding tissue

135
Q

giving drugs at a certain point of the cell cycle causes a profound effect on

A

the cell

136
Q

CELL CYCLES:
G1

A

dormant

137
Q

CELL CYCLES:
S

A

DNA & RNA synthesized

138
Q

CELL CYCLES:
G2

A

RNA made

139
Q

CELL CYCLES:
M

A

Mitosis

140
Q

CELL CYCLES:
G 0

A

resting

141
Q

Energy used in high doses to break the DNA chain in cancer cells

A

Ionizing radiation

142
Q

2 kinds of radiation

A

Internal & External

143
Q

Radiation effects cells in certain

A

CELL CYCLES

144
Q

Some tumors are more sensitive then others to

A

radiation

145
Q

treatment that is good for Hodgkin’s, Testicular cancer

A

radiation

146
Q

Treatment that has poor results with Gliomas, Melanoma

A

radiation

147
Q

External radiation uses ______ radiotherapy

A

Beam

148
Q

Internal radiation uses

A

implants

149
Q

Internal radiation is also called

A

brachytherapy

150
Q

External Radiation is also called

A

teletherapy

151
Q

Patient is alone in room during external radiation. EXACT spot to radiate is marked with identification such as

A

TATOO, PERMANENT INK MARKERS

152
Q

Wet Desquamation care:

A

wash gently & prevent infection

153
Q

Slough of upper layer of skin

A

Wet Desquamation

154
Q

Happens to 30% of patients 3 weeks after treatment

A

Wet Desquamation

155
Q

treatment includes cleaning and covering skin with a light, non-stick dressing

A

Wet Desquamation

156
Q

Erythema from radiation

A

Dry Desquamation

157
Q

Treatment includes cleaning skin with cool or warm water. no alcohol on skin

A

Dry Desquamation

158
Q

Fluids should be given to patients with dry or wet desquamation?

A

both

159
Q

type of ointment that is safe for dry desquamation

A

vitamin ointment

160
Q

Patient teaching for radiation:

Must avoid strong ______esp. over site of radiation

A

Sunlight. Wear sunscreen

161
Q

Patient teaching for radiation:

Eat ____ hours BEFORE treatment to decrease nausea:

A

2-3 hours

162
Q

Patient teaching for radiation:

Type of meal that can be eating before radiation

A

high protein, high carb, low residue

163
Q

Patient teaching for radiation:

Crowds are…..

A

sources of infection!!

164
Q

Patient teaching for radiation:

Women should avoid _____ during course of treatment

A

pregnancy

165
Q

Patient teaching for radiation:

Patients are tired because …….

A

WBC and RBC are destroyed

166
Q

A patient receiving radiation for breast cancer would experience which of the following side effects?
A. severe fatigue
B. mucositis
C. alopecia
D. vomiting

A

A. severe fatigue

167
Q

(Brachytherapy) Internal forms of radiation:

Source is placed inside tumor (seeds)

A

Interstitial

168
Q

(Brachytherapy) Internal forms of radiation:

Source is placed inside body cavity (cervical, breast, lung)

A

Intracavity

169
Q

(Brachytherapy) Internal forms of radiation:

Meds that are p.o. or IV that act as systemic radiation (I-131)

A

Radiopharmaceutical agents

170
Q

Brachytherapy commonly used to treat prostate cancer

A

interstitial

171
Q

All forms of brachytherapy emit ______ & carry specific safety precautions

A

radiation

172
Q

Internal radiation type:

Source of radiation is a sealed form of radium, cesium, etc. Placed in cavity or next to tumor

A

Intracavity

173
Q

Internal radiation type:

Used for local tumors such as mouth, cervix, testes, prostate

A

Intracavity

174
Q

Internal radiation type:

Bedrest is recommended to help avoid displacing implant

A

Intracavity

175
Q

Internal prostate seeds are kept in the body for how long?

A

Permanently

176
Q

When getting treatment with prostate seeds, avoid being around children for

A

the length of treatment

177
Q

Cervical Brachytherapy Procedure:

Give enema, douche & foley before insertion to avoid

A

BM and voiding

178
Q

Cervical Brachytherapy Procedure:

Implant remains in for _____ hours! After removal -enema & douche & remove catheter

A

48-144 hours

179
Q

Cervical Brachytherapy Procedure:

Patient is in hospital for ____ days

A

1-3 days

180
Q

Cervical Brachytherapy Procedure:

After removal of implant

A

enema & douche & remove catheter

181
Q

Cervical Brachytherapy Procedure:

Side effects

A

Fatigue, diarrhea, bladder irritation, decreased blood count, vaginal dryness

182
Q

Cervical Brachytherapy Safety:

Wear lead apron if ___ min with patient

A

> 30 min

183
Q

Cervical Brachytherapy Safety:

Stay greatest distance from pt. ___ ft is preferred in room

A

> 6 ft

184
Q

Cervical Brachytherapy Safety:

Trash, linen & food trays must be

A

screened by radiation officer before removal

185
Q

Cervical Brachytherapy Safety:

Patient must have private room with _____ to minimize exposure

A

bathroom

186
Q

P.O. radiation

A

UNSEALED INTERNAL RADIATION= Radiopharmaceuticals= I-131

187
Q

Unsealed internal radiation safety and procedure:

Isolate patient, ID room as radiation

Use ______, dispose of in trash which is left in room with linens for radiation officer to clear

A

paper plates

188
Q

Unsealed internal radiation safety and procedure:

Rotate staff to minimize exposure
Don double _____, _______, and _______

A

shoe covers, gown, and gloves

189
Q

Unsealed internal radiation safety and procedure:

No need for

A

lead apron (too restrictive, not effective for this type of radiation)

190
Q

Unsealed internal radiation safety and procedure:

Body fluids can go in toilet & be

A

flushed several times to clear with lid down

191
Q

Unsealed internal radiation safety and procedure:

2 weeks prior patient must start a _____ diet

A

low iodine diet

192
Q

Unsealed internal radiation safety and procedure:

Patient is hospitalized for _____ days to keep them isolated

A

2-3 days

193
Q

Unsealed internal radiation is commonly used for

A

Thyroid cancer

194
Q

Principles of Gamma radiation:

TIME: minimize exposure to

A

patient and limit family/visitors

195
Q

Principles of Gamma radiation:

Pregnant nurses

A

CANNOT take care of patient-

196
Q

Principles of Gamma radiation:

SHIELDING:

A

private room, lead lined walls good

197
Q

Principles of Gamma radiation:

DISTANCE:

A

maintain distance needed from patient. 6ft or greater is preferred

198
Q

Principles of Gamma radiation:

if implant falls out it must be handled with _______

A

FORCEPS & placed in lead lined garbage- Radiation officer is responsible for radiation monitoring

199
Q

Goal of chemotherapy

A

to destroy a % of tumor & allow body to destroy the rest

200
Q

Chemotherapy can affect normal cells with high rate of growth/cell turnover such as

A

hair follicles, lining of GI tract & bone marrow

201
Q

Chemotherapy can cure:

A

A.L.L., Hodgkins, Testicular

202
Q

A.L.L.

A

Acute lymphocytic (or lymphoblastic) leukemia

203
Q

Chemo can control:

A

Non-Hodgkins, ovarian, breast

204
Q

Chemo palliation:

A

to decrease size of tumor causing pain/obstruction

205
Q

Chemo for non-Hodgkins is _______

A

aggressive

206
Q

Chemo routes

A

oral
intramuscular
Intravenous
Subclavian catheters
implanted ports
intracavity
Intrathecal

207
Q

implanted ports are good because

A

patients require a lot of blood draws and frequent IV therapy

208
Q

inhibiting or preventing the growth and spread of tumors or malignant cells.

A

antineoplastic

209
Q

cytotoxic B lymphocytes and Killer T cells use these TSA’s to

A

identify and kill abnormal cells

210
Q

melanomas are very

A

aggressive cancers

211
Q

arising from plasma cells

A

myeloma

212
Q

chemo that bind with DNA or cell proteins to kill cells

A

Alkylating Agents

213
Q

Chemo drug:

good for slow growing leukemias, lympomas, breast/ovarian, testicular, pancreas

A

Alkylating Agents

214
Q

Chemo drug:

need to check BUN and creatinine before taking

A

cisplatin

215
Q

Chemo drug:

must be very hydrated before hanging

A

Alkylating Agents

216
Q

Chemo drug:

can cause renal toxicity and is an irritant

A

cisplatin

217
Q

Chemo drug:

Amifostine(Ethyol) and Mesna are protectant (rescue meds) and given

A

before chemo

218
Q

Chemo drug:

Protectant drug given to prevent h. cystitis

A

mesna

219
Q

Chemo drug:

ifosfamide is damaging to the kidneys and is given concurrently with

A

mesna

220
Q

Number 1 chemo drug is

A

Mustargen

221
Q

Chemo drug:

Replace necessary cellular metabolites = folic acid

A

Antimetabolites

222
Q

Chemo drug:

Antimetabolites that causes renal and liver toxicity

A

5-FU and methotrexate

223
Q

Chemo drug:

is the rescue med, protects the normal body cells from the toxic effects of methotrexate

A

leucovorin

224
Q

Chemo drug:

need folic acid supplements(1000 mg/day min)

A

Antimetabolites

225
Q

Chemo Drug:

blocks folic acid uptake

A

Antimetabolites

226
Q

Chemo Drug:

vesicants that cause necrosis

A

Antineoplastic Antibiotics

227
Q

Chemo drug:

infiltration can cause infection

A

vesicants

228
Q

Chemo drug:

side effects are cardiotoxicity and left ventricular disfunction, turns urine and body fluids red

A

bleomycin

229
Q

Chemo drug:

toxic to respiratory; causes pulmonary fibrosis

A

Antineoplastic Antibiotics

230
Q

Chemo drug:

cell cycle specific

A

Mitotic Inhibitors/Plant Alkaloids

231
Q

Chemo drug:

kill cells as mitosis begins

A

Mitotic Inhibitors/Plant Alkaloids

232
Q

chemo drug:

treats breast, small cell lung, sarcomas, hodgkin’s, ovarian

A

Mitotic Inhibitors/Plant Alkaloids

233
Q

Chemo drug:

The higher the dose the higher the chance of nerve damage

A

Mitotic Inhibitors/Plant Alkaloids

234
Q

Chemo drug:

causes a ton of side effects; alopecia and myelosuppression being the main ones

A

Mitotic Inhibitors/Plant Alkaloids

235
Q

How to prevent extravasation

A

Use central line or a recently placed IV; monitor infusion continuously

236
Q

A subcutaneous wash out involving injections of normal saline to the extravasation area.5,9This must be performed by appropriately trained professionals and may require multiple treatments

A

Flush out technique

237
Q

How to treat extravasation

A

Use cold or heat pack; cold to reduce swelling, heat to increase reabsorption

238
Q

Drug class:

specific to tissue/hormone; they decrease the amount of hormone or block receptor sites in tumor

A

Hormone modulator

239
Q

Drug:

slows rate of growth and spread of disease but can cause blood clots

A

Hormone Modulator

240
Q

Drug:

hormone regulator sometimes given for years

A

Tamoxifen

241
Q

Drug class:

when using an estrogen blocker the female patient will experience menopause very quickly

A

Hormone modulator

242
Q

Drug class:

block very specific proteins in cancer cells
with no effect on normal cells

A

Protein Tyrosine Kinase Inhibitors

243
Q

Drug :

treats chronic myelogenous leukemia; PO med that is very expensive

A

gleevec (imatinib)

244
Q

B lymphocyte antibodies that are created in response to lab antigen= kill cancer cells

A

monoclonal antibodies

245
Q

Drug:

monoclonal antibodies treatment for leukemias, RA, non-hodgkins

A

Rituxan (rituximab)

246
Q

Drug:

monoclonal antibodies treatment for breast cancer for HER2 +

A

Herceptin (trastuzumab)

247
Q

A group of potentially life-threatening conditions that may happen within hours after cancer treatment. Dying cells release large amounts of potassium, phosphate, and uric acid into the blood

A

Tumor lysis syndrome

248
Q

ANT

A

anemia, neutropenia, thrombocytopenia

249
Q

Using a lower dose but a combination of drugs

A

synergic effect

250
Q

When WBC does down to lowest level 1-2 weeks after treatment

A

myelosuppression

251
Q

Fever and low BP is sign of

A

systemic infection

252
Q

Patient with low platelet (thrombocytopenia) is at risk for

A

internal bleeding

253
Q

Monitoring temp for fever and signs of Nadir

A

100.4 3x in 24rs
101.3 1x in 24 hrs

254
Q

If absolute neutrophil count is <1000/mm

A

Reverse isolation is needed; minimum mask and gloves

255
Q

neutropenic precautions

A

Avoid flowers, produce, raw meats, razors, injections, manicures, pedicures, sick people and crowds

256
Q

Stomatitis and alopecia are side effects of

A

both chemo and radiation

257
Q

Care for stomatitis

A

soft toothbrush, mouth care q2h; normal saline or baking soda rinses (not commercial mouthwashes), lidocaine rinse

258
Q

If taking Adriamycin

A

keep out of sun

259
Q

chemo is very drying so skin care involves

A

moisturizing

260
Q

Zofran has 80% success with

A

Preventing nausea and vomiting

261
Q

Number 1 complaint is

A

fatigue

262
Q

Medication that blocks neurokinin (vomiting control center)

A

Emend

263
Q

SE Clotting/ bleeding:

Monitor lab values for

A

DVT, embolism, unusual bleeding,

264
Q

SE Clotting/ bleeding:

Assess for

A

petechiae, gum bleeding, OB stool, altered mental status

265
Q

SE Clotting/ bleeding:

Do not use or give

A

razors, rectal thermometers, aspirin, or ibuprofen

266
Q

Hormone regulator and some cancers can cause high risk of

A

clotting

267
Q

Precautions for Administration of Chemo:

when preparing chemo

A

Wear double gloves & mask

268
Q

Do not spray chemo in syringes

A

into the air

269
Q

a man-made form of granulocyte colony-stimulating factor; stimulates the growth of white blood cells in the body

A

NEUPOGEN

270
Q

a man-made form of granulocyte colony-stimulating factor; stimulates the growth of red blood cells in the body

A

Epogen

271
Q

Neupogen stimulates the bone marrow to produce

A

WBC

272
Q

Medical emergency; obstruction of superior vena cava by tumor- SOB, facial edema, headache, seizures

A

Superior vena cava syndrome

273
Q

Signs and symptoms of Hypercalcemia

A

lethargy, muscle weakness, EKG changes
Ca > 12mg
Treat: Fluids!

274
Q

Allopurinal(zyloprim)

A

treatment that reduces uric acid in body

275
Q

Med that causes diarrhea to reduce potassium level in blood

A

kayexalate

276
Q

Which of the following findings are possible in a patient with tumor lysis syndrome?
A. hypernatremia
B. edema of face and arms
C. epistaxis
D. hyperuricemia

A

D. hyperuricemia

277
Q

Several kinds of analgesics can be used because pain is

A

difficult to control

278
Q

Care with goal of symptom treatment

A

palliative care

279
Q

What statement indicates that the client understands teaching about neutropenia?
A. “I need to use a soft toothbrush.”
B. “I have to wear a mask at all times.”
C. “My grandchildren may get an infection from me.”
D. “I will call my doctor if I have an increase in temperature.”

A

D. “I will call my doctor if I have an increase in temperature.”

280
Q

A client is undergoing radiation therapy and asks the nurse about skin care for the exposed area. Which statement by the nurse is most accurate?
A. “No products work well to reduce the skin reactions you get from radiation.”
B. “No one product works best, so you can choose what you would like to use.”
C. “The only medication that works well for skin reactions is very expensive.”
D. “No good studies on skin care with radiation have been conducted to date.”

A

A. “No products work well to reduce the skin reactions you get from radiation.”

281
Q

In evaluating dietary teaching for a client with chemotherapy-induced neutropenia, the nurse becomes concerned when the client makes which food choice?
A. Fruit salad
B. Applesauce
C. Steamed broccoli
D. Baked potato

A

A. Fruit salad

282
Q

What teaching is essential for a client who has received an injection of iodine-131?
A. “Do not share a toilet with anyone else or let anyone clean your toilet.”
B. “You need to save all your urine for the next week.”
C. “No special precautions are needed because this type of radiation is weak.”
D. “Avoid all contact with other people until the radiation device is removed.”

A

A. “Do not share a toilet with anyone else or let anyone clean your toilet.”

283
Q

A client’s radiation implant has become dislodged overnight, and the nurse finds it in the client’s bed. What does the nurse do first?
A. Assess the client’s skin for radiation burns.
B. Use tongs to put the implant into the radiation container.
C. Notify the safety officer and move the client to a different room
D. Don gloves and attempt to replace the implant.

A

B. Use tongs to put the implant into the radiation container.

284
Q

client is receiving a chemotherapeutic agent intravenously through a peripheral line. What is the nurse’s first action when the client reports burning at the site?
A. Check for a blood return.
B. Slow the rate of infusion.
C. Discontinue the infusion.
D. Apply a cold compress

A

C. Discontinue the infusion.

285
Q

A client receiving intravenous chemotherapy asks the nurse the reason for wearing a mask, gloves, and gown while administering drugs to the client. What is the nurse’s best response?
A. “These coverings protect you from getting an infection from me.”
B. “I am preventing the spread of infection from you to me or any other client here.”
C. “The policy is for any nurse giving these drugs to wear a gown, gloves, and mask.”
D. “The clothing protects me from accidentally absorbing these drugs.”

A

D. “The clothing protects me from accidentally absorbing these drugs.”

286
Q

A client’s spouse reports that the last time the client received lorazepam (Ativan) before receiving chemotherapy, the client was extremely drowsy and didn’t remember the trip home. Which is the nurse’s best action?
A. Hold the dose of lorazepam for this round of chemotherapy.
B. Explain that this is a normal response to the drug.
C. Perform a Mini-Mental State Examination.
D. Document the response in the client’s chart.

A

A. Hold the dose of lorazepam for this round of chemotherapy.

287
Q

A client is on chemotherapy and has a platelet count of 25,000. Which intervention is most important to teach this client?
A. “Eat a low-bacteria diet.”
B. “Take your temperature daily.”
C. “Use a soft-bristled toothbrush.”
D. “Avoid alcohol-based mouthwashes.”

A

C. “Use a soft-bristled toothbrush.”

288
Q

A woman with chemotherapy-induced bone marrow suppression has received filgrastim (Neupogen). Which laboratory finding indicates that this therapy is effective for the client?
A. Hematocrit is 35%.
B. Hemoglobin is 14/dl
C. Red blood cells 5/mcl
D. White blood cells (neutrophils) 3500

A

D. White blood cells (neutrophils) 3500

289
Q

What is the priority problem for a client experiencing chemotherapy-induced anemia?
A. Risk for injury related to fatigue Correct
B. Fatigue related to decreased oxygenation
C. Body image problems related to skin color changes
D. Inadequate nutrition related to anorexia

A

A. Risk for injury related to fatigue Correct
B. Fatigue related to decreased oxygenation

Med/Surg (17 decks)

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