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Block 2 Exam 4 > Treatment > Flashcards

Treatment Flashcards

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1
Q

EBRT (radiation) - what is it and how often is tx?

A

Radiation beams from different angles externally
Daily tx over few days - few weeks

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2
Q

What is brachytherapy?

A

Internal radiation tx inside little seeds placed on or next to tumor

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3
Q

Precautions to protect caregivers during radiation tx / brachytherapy

A

Private room
Signage
No pregnant staff or visitors
No children visitors
30 minute visit
6 foot distance

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4
Q

What is HSCT (stem cell therapy) used for?

A

Myeloma
Leukemia
Lymphoma

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5
Q

Precautions to protect caregivers during chemo

A

Manage spills
Proper disposal
Double glove
Cover toilet and double flush

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6
Q

Infection prevention with chemo patients

A

VS q4h
Private room
Hand hygiene
Stool softeners
Change water daily
No urinary catheters

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7
Q

Nursing for hand and foot surgery

A

Neuro vascular checked q1h first 24 hours post
Meds, elevation, ice
Wound and pin care
Weight bearing restrictions

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8
Q

Methods to prevent dislocation post hip replacement

A

Correct positioning with splint, wedge, or pillows
Keep hip abducted when turning
Keep hip adducted when transferring
Limit hip flexion
Stay less than 90 degrees in bed

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9
Q

Hip replacement nursing/education

A

Begin ambulating within 1 day post op with walker or crutches
Remove drain in 24-48 hours to prevent infection
Prevent infection and VTE

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10
Q

Osteoporosis prevention

A

Ca and vitamin D
Vitamin C with Ca supplements
Weight bearing exercise 20-30 minutes a day

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11
Q

Nursing for osteoporosis vertebral fracture

A

Short rest periods
Supportive mattress
Heat and back rubs
Improve bowel elimination with fiber, liquids, and stool softeners
Strengthen muscles with exercise

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12
Q

Osteomalacia mgmt

A

Sunlight (along with pharm and coping and pain mgmt)

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13
Q

Osteomyelitis nursing

A

Immobilize affected part
Elevation
Analgesics and abx (monitor for superinfection)
Activity restriction
Gentle ROM above and below affected part
Hydrate, vitamins, protein

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14
Q

Septic arthritis

A

Aspiration of joint
Immobilization of joint
Pain relief
Abx

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15
Q

Metastatic secondary bone tumor nursing

A

Palliative

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16
Q

Soft tissue injury mgmt

A

RICE = rest ice compress elevation
And immobilize

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17
Q

Emergency management of fracture

A

Immobilize
Splint areas distal and proximal
Neuro vascular checks before and after splint

If open fracture: cover with sterile dressing, don’t attempt to reduce

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18
Q

Medical mgmt fracture

A

Reduction back into alignment
Traction with closed
Fixation with opened
Immobilize

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19
Q

Factors that affect bone healing

A

Inadequate immobilization
Inadequate blood supply
Multiple trauma
Extensive blood loss
Infection
Poor adherence to restrictions
Malignancy
Steroids
Older
Comorbidities

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20
Q

Clavicle fracture

A

Sling
Exercise elbow, wrist, fingers ASAP
Don’t elevate arm 6 weeks
(Also strap to immobilize)

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21
Q

Humerus fracture

A

Sling and brace
Activity limitations
Monitor for Volkmann

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22
Q

Elbow fracture

A

Monitor for Volkmann contracture from humerus fracture, neuro vascular compromise, and compartment syndrome
Active exercise and ROM after healing (6 weeks cast, 1 week fixation)

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23
Q

Radial, ulnar, wrist, hand fractures

A

Early rehabilitation exercises
ROM fingers and shoulder

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24
Q

Pelvic fractures

A

Bed rest few days if stable fracture
Early mobilization

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25
Q

Hip fracture

A

Surgery to reduce and fixate
Similar to hip replacement patients (i.e. preventing overstretching the hip)

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26
Q

Femoral fractures

A

Lower leg, foot, hip exercises to preserve muscle function and improve circulation
PT, ambulation, weight bearing
Knee exercises ASAP

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27
Q

Edu and mgmt for patient in cast, brace, or splint

A

Cast takes 24-72 hours to dry
Don’t cover or stick things in cast
Assess 5 Ps (pain, pallor, pulse, paresthesia, paralysis) in neuro vascular check (to ID compartment syndrome)
Tx pain with analgesic, elevation, ice
Monitor for compartment syndrome, pressure injuries, disuse syndrome (atrophy)

28
Q

Principles of traction

A

Counterforce
Continuous
Unobstructed
Knots and footplate can’t touch foot of bed

29
Q

Nursing for skin traction

A

Skin assessment TID
Palpate tape for tenderness
5 Ps
Temp, cap refill
Assess for DVT

30
Q

Nursing for skeletal traction

A

Maintain body alignment
Report pain promptly
Trapeze
Assess for pressure injury q8h
Position change
Pressure reducing mattress
Foot and leg exercises q1h
Embolism prevention
Pin care

31
Q

Prevention of sports injuries

A

Proper training
Gear
Nutrition
Hydration
Stretching

32
Q

Amputation nursing

A

Relieve pain with analgesics, position, sandbag, alternative measures
Psychological support
Self care
Frequent turning
ROM
Assistive devices
Muscle strengthening exercises
Proper bandaging
Elevate first 24 hours
Fall prevention and home modification

33
Q

Guidelines for early detection of breast cancer

A

MRI and yearly mammogram for high risk
Clinical breast exams twice a year starting at 25 yo

34
Q

Prophylactic tx breast CA

A

Mastectomy
Tamoxifen and raloxifene

35
Q

Breast CA tx

A

Surg: modified radical, total, breast conservation, sentinel node biopsy and axillary node dissection
Radiation, chemotherapy, hormonal, targeted

36
Q

Cast edu

A

Will feel warm first 30 minutes
Don’t cover
Don’t rest on hard surface while drying
24 - 72 hours to dry
Don’t stick stuff in there
Isometric exercises

37
Q

Interventions to maintain airway with altered LOC

A

HOB 30
Lateral or semi prone
Suction
Oral hygiene
CPT

38
Q

Interventions to maintain tissue and structural integrity with altered LOC

A

Frequent turning
Splints, boots, rolls for body alignment
Passive ROM
Protect cornea with drops, cotton balls with saline, tape, patch
Frequent oral care

39
Q

Pre op mgmt for cranial surgery

A

Imaging and baseline neuro
Anti convulsants
Steroids and abx
Fluid restriction, Mannitol, diuretics
Diazepam for anxiety

40
Q

Post op mgmt cranial surgery

A

Reduce edema, pain, seizures
Neuro assessment
Might be intubated and have lines
Resp and ABG assessments
Assess dressing for blood and CSF
VS and LOC
Fluid and labs (IO and weights, BG, electrolyte, osm and specific gravity)
HOB 30, straight neck, avoid laying on side of tumor removal
Pack nose if transsphenoidal
Avoid increasing ICP

41
Q

Edu for cranial surgery

A

No cough/sneeze/nose blow etc to avoid CSF leakage
Self care

42
Q

Seizure mgmt

A

Side lie
Suction
Padding

43
Q

Stroke prevention

A

No smoke
40 minutes a day 3-4 x/week exercise
DASH and Mediterranean
Daily low dose aspirin
Anticoagulants for a fib, antiplatelets
Statins, BP meds
Carotid endarterectomy for carotid stenosis

44
Q

Acute stroke mgmt

A

TPA thrombolytic within 3 - 4.5 hours (monitor for bleeding adverse effect)
Elevate HOB
Airway, hemodynamic, neuro
Bowel and bladder
Skin, confusion, mobility
Swallow eval within 24 hours (NPO til then)

Hemorrhagic: lumbar puncture to confirm SAH, prevent bleeding, bed rest with sedation, O2, tx of: vasospasm, HTN, ICP, seizure

45
Q

Epidural hematoma

A

Reduce ICP
Remove clot
Burr holes / craniotomy to stop bleeding
Support of vitals and respiratory

46
Q

Acute subdural hematoma

A

Craniotomy to reduce ICP
Also: remove clot

47
Q

Chronic subdural hematoma

A

Remove clot

48
Q

Concussion

A

Monitor LOC
Arouse and assess frequently

49
Q

Encephalitis

A

Acyclovir
Amphotericin

50
Q

MS nursing

A

Control ss: spams, fatigue, ataxia, bowel and bladder control

51
Q

GBS assessment (fatal complications)

A

Look for early ss respiratory failure, dysrhythmia, DVT
ECG

52
Q

Head injury mgmt

A

Assume SCI
Cervical collar
CV and resp maintenance
Control bleeding
Maintaining ABG
Surg
Monitor ICP
Drain CSF
Seizure precautions
NGT
F and lyte
Pain and anxiety mgmt
Nutrition

53
Q

TBI nursing

A

Airway
GCS
VS
IO and weights
Labs (BG, lytes, osm)
Nutrition therapy
Assess oxygenation, bowel and bladder, dressing and cast constriction
Padded side rails and mittens

54
Q

Nursing for SCI includes…

A

Secretion
Pulse ox and ABG
Humidification
Skin
Urinary catheter
NGT for distention, paralytic ileus and prevent aspiration
Diet: high calorie, high protein, high fiber
Stool softeners
Traction pin care

55
Q

Meningitis prevention

A

Meningococcal vax
Iso with droplet precautions

56
Q

Meningitis tx

A

IV abx
Dexamethasone
Tx for pain, seizures, complications associated with immobility

57
Q

Brain abscess mgmt

A

Control ICP / drain
Abx, roids

58
Q

Nursing for MS includes

A

Comfortable temperature
Memory aids
Speech therapy
Voiding schedule

59
Q

Bell’s Palsy mgmt

A

Roids
Protect eye
Facial exercises and massage

60
Q

Nursing for brain tumor includes

A

Oral hygiene before meals
Supplements
Try to serve them meals that are to their liking
Record intake and weight

61
Q

Parkinson’s

A

Levodopa-carbidopa
Daily exercise and ROM
Postural exercises
Frequent rest
Proper shoes and assistive devices
Self care and support groups

62
Q

Mgmt lumbar disc disease

A

Muscle relaxants
NSAIDS
Roids
Lose weight
TENS
Surg
Avoid heavy work 2-3 months
Strengthen core and back muscles
Proper lifting techniques

63
Q

Mgmt osteoarthritis

A

Decrease pain and stiffness
Exercise - CV, leg day
Lose weight
OT and PT
Pharm and non pharm pain mgmt

64
Q

Nursing mgmt with HSCT

A

Care for patient and recipient

65
Q

Nursing mgmt for traction (mostly r/t bed rest)

A

Monitor for:
PNA and ATE
Constipation
Anorexia
Urine status
Infection
VTE
(Also skin)

66
Q

Ischemic stroke nursing

A

Splint affected extremity to avoid flexion
Pillow under arm to prevent shoulder adduction
Turn and ROM
Avoid pully to prevent shoulder pain
Sling for flaccid arm
Thick liquid and puréed
(Or tube feeding - depends on condition)
High fiber and fluids for constipation
Toileting schedule, straight cath
Skin care and other bed bound considerations (pulmonary, VTE)

Block 2 Exam 4 (6 decks)

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