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Exam 1 Flashcards

(114 cards)

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1
Q

Grade 1 Cancer Cells

A

cells differ slightly from normal cells

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2
Q

Grade 2 Cancer Cells

A

Cells are more abnormal (moderately differentiated)

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3
Q

Grade 3 Cancer Cells

A

Cells are very abnormal (poorly differentiated/ high grade)

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4
Q

Grade 4 Cancer Cells

A

cells are immature (undifferentiated/high grade)

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5
Q

Grade 5 Cells

A

grade cannot be assessed

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6
Q

If a cell if more differentiated what does that mean?

A

The patient has a poorer prognosis

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7
Q

What is the main treatment for cancer?

A

Chemotherapy

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8
Q

What effect does chemotherapy have on cells?

A

It eliminates/ reduces the # of cancer cells in the primary cancer site

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9
Q

what are the two categories of chemotherapy?

A

Cell cycle nonspecific and cell cycle specific

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10
Q

What is the way we maximize effectiveness when administering chemotherapy?

A

Specific and nonspecific are usually given together to maximize effectiveness

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11
Q

What should do nurse do to manage symptoms of bone marrow suppression from chemotherapy?

A

•Monitor CBC (Esp. neutrophils)
•Monitor Platelets (Thrombocytopenia) +avoid bleeding risks
•Monitor RBC (Anemia)
•Monitor body temperature

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12
Q

What should the nurse do to manage fatigue symptoms from chemotherapy/radiation?

A

•Teach energy conversation strategies

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13
Q

What should the nurse do to manage GI symptoms from chemotherapy/radiation?

A

•Give antiemetic 1hr prior to tx
•Place on low fiber diet (avoid dairy)
•Take lukewarm sitz baths
•Monitor for skin breakdown
•Tell pt to keep record of episodes

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14
Q

What should the nurse do to manage symptoms of mucositis from chemotherapy/radiation?

A

•Frequent oral assessments
•Q6 months dental visits
•Educate taste loss is common

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15
Q

what should the nurse do to manage symptoms of anorexia from chemotherapy/radiation?

A

•Monitor for weight loss
•Offer small frequent meals, high protein
•Monitor for dehydration

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16
Q

What should the nurse do to manage skin reactions from chemotherapy/radiation?

A

•Avoid hot packs,tight clothes, harsh chemicals
•Use nonirritating lotion, cover with vaseline covered gauze
•Place cold cap on head prior to Tx to avoid alopecia

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17
Q

What should the nurse do to manage pulmonary effects from chemotherapy/radiation?

A

Monitor for cough, dyspnea, and pulmonary edema

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18
Q

What should the nurse do to manage cognitive effects from chemotherapy/radiation?

A

monitor for “chemo” brain
patient will have difficulty thinking and remembering

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19
Q

Warning Signs for Cancer “CAUTION”

A

C- Change in bowel/ bladder habits
A- A sore that does not heal
U-Unusual bleeding
T-Thickening of lump
I- Indigestion/ difficultly swallowing
O- Obvious change in wort
N- Nagging cough

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20
Q

What are life threatening emergencies that occur due to cancer treatment?

A

•Spinal Cord Compression
•Superior Vena Cava Syndrome
•Third Space Syndrome
•Hypercalcemia
•SIADH
•Tumor lysis syndrome
•Cardiac Tamponade
•Cardiac artery rupture

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21
Q

How should the nurse manage cancer pain?

A

•Preform pain assessments routinely
•Ask PQRST questions
•Use drug therapy (NSAIDs + Opioids)

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22
Q

What are isotonic solutions used for?

A

Hydration

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23
Q

Examples of Isotonic solutions

A

0.9% NS, LR, D5W

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24
Q

What are hypotonic solutions used for?

A

Tx for N/V, DKA, Hemorrhages, Cardiac and renal patients

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25
Examples of Hypotonic solutions
0.45% saline, 1/4 Saline, 1/3 Saline
26
What are hypertonic solutions used to treat?
Fluid overload, TBI, Burns, Hyponatremia, Ascites
27
Example of Hypertonic solutions
3% Saline, 5% Saline, D10W, 5% Dextrose w/ LR, 5% Dextrose w/ 0.45%
28
What are ways we can move fluid from the body?
•Dialysis •Diuretics (Oral or IV) •Fluid + Sodium restriction •Pleural Effusion
29
What is 1st spacing?
normal distribution of fluid
30
What is 2nd spacing?
abnormal accumulation of fluid (edema)
31
What is third spacing?
Fluid is trapped Common w/ burns, acities, trauma
32
Why do geriatric patients have difficulties moving fluid?
kidneys decrease in renin and there is subcutaneous tissue loss
33
Define hypervolemia
excess intake of fluids
34
Define Hypovolemia
loss of body fluid
35
What nursing interventions are important for fluid volume imbalances?
•Daily weights (2lb is significant) •Monitor labs (BUN, Hct, Sodium) •Offer fluids q1-2 hours •Assess RR, Crackles in lungs, SOB
36
How is hypernatremia treated?
Replace with isotonic or hypotonic solutions
37
how should the nurse manage hypernatremia?
•monitor sodium levels •initiate seizure precautions •place on sodium restricted diet
38
How is hyponatremia treated?
Hypertonic solution, usually small amounts of 3% sodium chloride
39
how should the nurse manage hyponatremia?
•Place on fluid restriction •Hold diuretics •Initiate seizure precautions
40
Why should you not increase sodium levels too fast?
Can result in damage to nerve cells in the brain
41
What is the treatment for hyperkalemia?
Diuretics and dialysis
42
how should the nurse manage hyperkalemia?
•hold oral and other potassium intake •Monitor EKG and BP
43
What is the treatment for hypokalemia?
Replace orally or IV but should not exceed 10 mEq per hour
44
What are the risk factors for developing skin cancer?
•having skin cancer •blonde or red hair •suntanning or indoor tanning bed •living near equator •family hx •outdoor occupations
45
What is actinic keratosis and what causes it?
most common precancerous lesions, usually caused by sun damage
46
What are the characteristics of actinic keratosis?
Flat, scaly, wart like
47
What is basal cell carcinoma?
most common form of skin cancer but least deadly
48
What are the characteristics of basal cell carcinoma?
pearly, eroded papule
49
What is squamous cell carcinoma?
Most aggressive form of skin cancer
50
What are the characteristics of squamous cell carcinoma?
thin, scaly, horn like
51
What is a superficial burn?
a 1st degree burn that effects only the outer layer of the skin
52
What are characteristics of a superficial burn?
painful, erythema, blanches, swelling
53
What is a deep/partial thickness burn?
a second degree burn that involves the outer layer (epidermis) and part of the dermis
54
What are the characteristics of a deep/partial thickness burn?
red, shiny, wet, fluid filled vesicles
55
What is a full thickness burn?
3rd and 4th degree burns that’s destroy all three layers of skin and sometimes the subcutaneous tissue
56
What are the characteristics of a full thickness burn?
Dry, waxy, leathery, white
57
What is the emergent phase of burns?
The time needed to resolve the immediate issues resulting from the burn injury
58
How does a burn patients fluid and electrolyte shifts present clinically?
•Low BP + High HR •High Hct due to fluid loss •Potassium + Sodium elevated due to the rapid shift and it staying there •Third spacing will occur
59
What is the parklins formula?
4ml x % Body Surface x Weight (kg)
60
According to the parklins formula, how should fluid be given?
Give 1/2 of the total in 1st 8 hours 1/4 in the next 8 hours 1/4 in the last 8 hours
61
What is type 1 diabetes?
Patient produces little to no insulin
62
What are the characteristics of T1DM?
Symptoms are abrupt •polyuria •polyphagia •polydipsia •sudden weight loss
63
What is Type 2 diabetes?
Doesn’t use insulin properly, insulin resistant
64
what are the characteristics of T2DM?
often show no symptoms, often due to obesity, family hx, lack of exercise
65
How is diabetes diagnosed?
A1C 6.5 or greater Fasting Plasma Glucose of 126 or higher 2 hour plasma glucose level of 200 or higher
66
What are the names of rapid acting insulin?
Lispro (Humalog), Avart (Novolog)
67
What is the onset, peak and duration of rapid acting insulin?
Onset 10-30 min Peak 30 min-3 hours Duration 3-5 hours
68
What are the names of short acting insulin?
Novolin R, Humulin R
69
What is the onset, peak, and duration of short acting insulin?
Onset 30 min- 1 hour Peak 2-5 hours Duration 5-8 hours
70
What are the names of intermediate acting insulin?
NPH (Humulin N, Novolin N)
71
What is the onset, peak, and duration of intermediate acting insulin?
onset 1.5-4 hours peak 4-12 hours Duration 12-18 hours
72
What should you get during the first 24-48 hours of a smoke inhalation injury?
Bronchoscopy
73
What are the names of long acting insulin?
Lantus, Levemir
74
What is the onset, peak, duration of long acting insulin?
onset 0.8-4 hours NO PEAK Duration 16-24 hours
75
What levels do you check after inhalation injury?
Lactic Acid Carbon Monoxide level (Coximeter or Carboxyhemoglobin)
76
What is the treatment for carbon monoxide toxicity?
Give 100% oxygen, non rebreather or hyperbaric
77
What test should be done for a patient with electrical burns and why?
EKG, arrhythmia's may have occurred
78
Where do you send circumferential burn patients?
burn center
79
What do you cover large thermal burns with?
Wrap in clean sheet/ blanket
80
What are the clinical findings in the emergent phase of burns?
Pain Blisters Paralytic ileus Shivering Altered mental status
81
What pain med should a burn patient be treated with and why?
IV Fentanyl, Only opioid that does not lower blood pressure
82
What is the treatment route for paralytic ileus in burn patients?
Get the patient fed ASAP (tube feed, etc)
83
When do we start fluid resuscitation for burn patients?
Greater than 15% total body surface area
84
What immunization is given routinely to burn patients?
Tetanus
85
What is the somogyi effect?
Hyperglycemia in the morning due to blood glucose decreasing in the middle of the night resulting in rebound hyperglycemia
86
What are symptoms of somogyi effect?
Pt reports night sweats or terrors
87
What is the treatment to prevent somogyi effect?
Give snack before bed
88
What is the dawn phenomenon?
Hyperglycemia in the morning due to excess release of cortisol and growth hormone in early hours
89
What is the treatment to prevent dawn phenomenon?
Increase insulin dose or the time it is administered
90
What is the most common respiratory issue with DKA and Hyperglycemia?
Kussumal respirations
91
What is the nursing management for DKA and hyperglycemia?
IV fluids, Insulin therapy, EKG, LOC, electrolytes
92
How many carbs should be given if a patient is hypoglycemic and what type of carbs?
15g and fruit juice
93
What carbs should be avoided to a hypoglycemic patient?
Carbs containing fats (Milk and Ice cream)
94
If a patient is unconscious, what is the treatment for hypoglycemia?
Give IV dextrose, IM/SubQ Glucagon, do not give anything oral
95
What is acromegaly?
Overproduction of growth hormone
96
What is SIADH?
Symptom of inappropriate antidiuretic syndrome overproduction of ADH which can then cause FVE or FVD
97
What are S/S of SIADH?
Low urine output increased weight thirst headaches, n/v, cramping
98
what nursing management should be implemented for SIADH?
Monitor Na+ levels accurate i/os place on fluid restriction daily weights give diuretic’s
99
What is cushing’s syndrome?
excess ACTH (cortisol) produced
100
What is addison’s disease?
Too little cortisol produced
101
What is diabetes insipidus?
not enough ADH produced to regulate how it handles fluids
102
what are s/s of diabetes insipidus?
nocturia, polyuria in severe cases low bp high Hr
103
How is diabetes insipidus diagnosed?
a water deprivation test for 8-12 hours
104
What meds are used for diabetes insipidus?
Chloropropamide, Tegretol, Thiazide diuretics, NSAIDS
105
What is the most common form of hyperthyroidism?
Graves’ disease
106
What are the s/s of hyperthyroidism?
Irritable, decrease attention span, increased appetite, decreased weight, goiter, tachycardia, htn
107
What are treatment options for hyperthyroidism?
antithyroids, iodine, beta blockers or a thyroidectomy
108
What are the s/s of hypothyroidism?
low energy, weight gain, cold intolerance, myxedema, low BP, Low HR, decreased appetite
109
What is important to educate to your hypothyroidism patients?
treatment is life long and to eat a low calorie diet
110
What is hypothyroidism treated with?
levothyroxine in low doses
111
Hormones of the endocrine system
FLAT PEG FSH LH ACTH TSH Prolactin Endorphin Growth Hormone
112
What is the relationship of plasma osmolarity and ADH release?
When osmolarity increases it triggers your body to make ADH. This then tells the kidneys to keep more water inside your blood vessels and will result in your urine to become more concentrated
113
What is the normal urine specific gravity level ?
1.005-1.030
114
What will the result of a urine specific gravity be of a patient who has SIADH or Diabetes Insipidus?
urine specific gravity will be low

Med Surg 2 (6 decks)

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