Nursing Considerations

Question 1

People with brain tumors are at increased risk for what?

Answer 1

VTE

Question 2

What should you educate your patient who is receiving radiation to the brain about?

Answer 2

Short term side effects may be headache, hair loss, N/V, hearing loss, skin and scalp changes, trouble with memory or speech, seizures

Question 3

What should you educate your patient who is receiving radiation to the breast about?

Answer 3

Avoid bras with underwire, nylon or lace
Deodorant but avoid shaving armpits

Question 4

What should you educate your patient who is receiving radiation to the head or neck area about?

Answer 4

If having dry mouth, use mouthwash solution of 1qt water + 1tsp salt + 1tsp baking soda

See a dentist before radiation to check for secretly decayed teeth or oral infection

Question 5

What should you educate your patient who is receiving radiation to the pelvis about?

Answer 5

If younger patients, sexuality and infertility. Sperm banking and egg harvesting

Question 6

Radiation symptom management: fatigue

Answer 6

Prioritize and delegate responsibilities, daily gentle exercise

Question 7

Radiation symptom management: anorexia

Answer 7

Small, frequent meals, change diet and environment, stimulate appetite (marinol), nutritious and high protein snacks, avoid fatty or greasy foods, nutritional supplement

Question 8

Radiation symptom management: mucositis

Answer 8

Avoid irritate such as tobacco, alcohol, spicy and acidic foods, hot drinks
Frequent oral care with saline and water

Question 9

Radiation symptom management: xerostomia

Answer 9

Moisten foods, artificial saliva, avoid dry foods, soak food in coffee, milk, or warm drinks; frequent saline rinses

Question 10

Radiation symptom management: alopecia

Answer 10

Gently brush or comb, decrease frequency of shampooing, avoid hair dye or chemicals, wig

Question 11

Radiation symptom management: nausea and vomiting

Answer 11

Small, frequent meals, drinking clear or cool beverages, avoid overly sweet/greasy/fatty foods, rest with head elevated after eating, antiemetics

Question 12

Radiation symptom management: bone marrow suppression

Answer 12

If large bone within the field of radiation, possibly weekly CBC, observe for S&S of bleeding and infection, transfusion support

Question 13

Pts going though HSCT, teach to do what to avoid mouth sores?

Answer 13

Cryotherapy before, during, after administration of melphalan

Or palifermin

Question 14

What teaching needs to be done to prevent hemorrhagic cystitis?

Answer 14

Nurse will administer mesna (a neuroprotectant) and vigorous hydration and pt should void frequently, even at night.

Question 15

Considerations when patient thrombocytopenia?

Answer 15

Avoid invasive procedures (rectal temp, finger sticks, enemas, IM injections), tampons, sex, use stool softeners or laxatives, immediately report sudden onset of headache

Question 16

Considerations for pt receiving radiation therapy?

Answer 16

No topicals within 4 hours of radiation
Use high potency steroids daily for duration of radiation dermatitis
Concurrent PO abx
Topical abx
Pain control with NSAIDs, gaba receptor agonists, and narcotics

Question 17

What is considered abnormal for cardiac function?

Answer 17

EF <45% or a 5% decrease from baseline

Question 18

At what %weight loss should you consult a dietician?

Answer 18

10%

Cachexia has an unfavorable impact on treatment outcome

Question 19

Autonomic symptoms of neuropathy

Answer 19

Constipation, urinary retention, sexual dysfunction, BP alterations

Assess bowel sounds, pulse variations with Valsalva maneuver, presence of orthostatic pressure

Question 20

With chronic pain, what symptoms are absent?

Answer 20

Autonomic symptoms: elevated BP, tachycardia, pale, diaphoresis

Question 21

Is Cancer-related fatigue relieved by sleep or rest?

Answer 21

Typically, no. May need to assess if disease progression, need antidepressant? Psychstimulant? Corticosteroids?