Week 5: Lung Cancer Flashcards
Lung cancer has the highest mortality rate
T or F?
True
What is the peak incidence of lung cancer?
Peak incidence in ages 55-65
Most commonly in those with hx of smoking between 40-75
Which subcategory of lung cancer is more aggressive with higher rates of metastases and mortality?
Small cell lung cancer
What are the common manifestations of lung cancer?
Chronic cough/chest congestion, hoarseness, fatigue, progressive dyspnea, productive cough with frothy sputum, hemoptysis, lymphadenopathy, weight loss
*Bc many lung cancer pts have a hx of smoking, they likely also experience many of these symptoms, key to look for changes/worsening in chronic symptoms
Which statement indicates a need for further teaching regarding alopecia?
a) “My hair will thin and start to fall out in 1 to 2 months.”
b) “I need to wear a hat or scarf when I am outside working.”
c) “The chemotherapy may cause me to lose all my body hair.”
d) “Washing my hair with a mild shampoo will prevent hair loss.”
D- some interventions may delay hair loss, but it cannot be prevented
List interventions to manage pt dyspnea?
-Semi/high Fowlers position to allow for maximal lung expansion
-Teach him how to use diaphragmatic and pursed-lip breathing
-Decrease activity level – teach him to pace himself with activities
-Assess anxiety component - consider a referral to psychosocial support services
-Utilize Oxygen therapy as needed
-Administer medications such as morphine
-Encourage maximal fluid intake to maintain hydration
When assessing a pt 2 hours after thoracentesis, what information should be reported to the MP?
a) occasional chest pain when taking deep breaths.
b) some burning and stinging at the thoracentesis site.
c) a small amount of serosanguineous drainage on the dressing.
d) a blood pressure of 90/50 mm Hg and an increase in dyspnea.
D
Removing large quantities of fluid from the pleural space can cause fluid to shift from the vascular spaces into the empty pleural space, causing symptomatic hypotension and tachycardia
You would need to monitor VS, lung sounds, and chest movements and immediately report any hypotension, dyspnea, and asymmetrical chest movements. Some bleeding at the site is normal, as are continued complaints of some pleuritic pain.
What is a normal WBC count?
5,000-10,000
Your pt on chemotherapy has an NA value of 131 and a Cl of 90.
What is a normal sodium and chloride value?
What might this indicate?
Normal Na= 135-145
Normal Cl=98-106
Low Na and Cl indicate salt wasting, a symptom of nephrotoxicity which is a common adverse effect with chemotherapy
The client diagnosed with LC is being discharged. Which statement made by the client indicates that more teaching is needed?
1. It doesn’t matter if I smoke now. I already have cancer.
2. I should see the oncologist at my scheduled appt.
3. If I begin to run a fever I should notify my HCP.
4. I should plan for periods of rest throughout the day.
1- Smoking interferes with cancer treatment
The client is admitted to the outpatient surgery center for a bronchoscopy to rule out lung cancer. Which info should the nurse teach?
1. The test will confirm the MRI results.
2. The client can eat and drink immediately after the test.
3. The HCP can do a biopsy of the tumor through the scope.
4. There is no discomfort associated with this procedure.
3
Which clinical manifestation would the nurse expect to find in newly diagnosed intrinsic LC?
1. Dysphagia
2. Foul smelling breath
3. Hoarseness
4. Weight loss
3- Hoarseness is an early sign
An emergency department nurse is interviewing a client with signs of an ischemic stroke that began 2 hours ago. The client reports that she had a cholecystectomy 6 weeks ago and is taking digoxin, coumadin, and labetelol. This client is not eligible for thrombolytic therapy for which of the following reasons?
a) She is not within the treatment time window.
b) She had surgery 6 weeks ago.
c) She is taking digoxin.
d) She is taking warfarin.
She is taking cwarfarin.
To be eligible for thrombolytic therapy, the client cannot be taking warfarin. Initiation of thrombolytic therapy must be within 3 hours in clients with ischemic stroke. The client is not eligible for thrombolytic therapy if she has had surgery within 14 days. Digoxin and labetelol do not prohibit thrombolytic therapy.
Which disturbance results in loss of half of the visual field?
a) Anisocoria
b) Homonymous hemianopsia
c) Nystagmus
d) Diplopia
Homonymous hemianopsia
Homonymous hemianopsia (loss of half of the visual field) may occur from stroke and may be temporary or permanent. Double vision is documented as diplopia. Nystagmus is ocular bobbing and may be seen in multiple sclerosis. Anisocoria is unequal pupils.
A client is hospitalized when they present to the Emergency Department with right-sided weakness. Within 6 hours of being admitted, the neurologic deficits had resolved and the client was back to their presymptomatic state. The nurse caring for the client knows that the probable cause of the neurologic deficit was what?
a) Cerebral aneurysm
b) Transient ischemic attack
c) Left-sided stroke
d) Right-sided stroke
Transient ischemic attack
A transient ischemic attack (TIA) is a sudden, brief attack of neurologic impairment caused by a temporary interruption in cerebral blood flow. Symptoms may disappear within 1 hour; some continue for as long as 1 day. When the symptoms terminate, the client resumes his or her presymptomatic state. The symptoms do not describe a left- or right-sided stroke or a cerebral aneurysm.
