Exam 1

Question 1

Hypernatremia - assess findings & interventions

Answer 1

Lethargy, stupor, comatose, increased thirst, muscle twitching/contracting and progressive muscle weakness.

intervention: reduce slowly - push fluids. If unable to take water PO, use D5W or half normal saline 0.45%

Question 2

Hyponatremia

Answer 2

Cerebral edema, increased ICP, seizures, coma, death

intervention: increase slowly – IV sodium chloride or 3% saline

Question 3

Hyperkalemia

Answer 3

ECG changes, bradycardia, hypotension, muscle twitching, tingling or burning sensations. Frequent watery diarrhea

intervention: diuretics (non-potassium sparing), glucose/insulin therapy to drive potassium back into cells, lower potassium consumption, dialysis in SEVERE cases

Question 4

Hypokalemia

Answer 4

hypoactive bowels, ECG changes, dysrhythmias, weak thready pulse, altered mental status, increased agitation

interventions: discontinue laxatives/diuretics, Use potassium sparing diuretics, if necessary, control hyperglycemia,

Question 5

Hypercalcemia

Answer 5

Hypercalcemia – Increased HR and BP, poor perfusion as measured by cyanosis and cap refill, muscle weakness, decreased deep tendon reflexes, constipation, N/V, anorexia,

interventions: calcitonin, IV fluids to reduce concentration

Question 6

Hypocalcemia

Answer 6

Muscle cramps, especially in the lower legs (Charley Horses), positive Trousseaus and Chvostek signs

interventions: TUMS (calcium supplements), review dietary intake of vitamin D and fats (these can impair calcium absorption)

Question 7

Hypermagnesemia

Answer 7

Bradycardia, hypotension, lethargy, slow or absent deep tendon reflexes, all getting worse as imbalance progresses

interventions: avoid magnesium antacids/laxatives, administer magnesium wasting diuretics

Question 8

Hypomagnesemia

Answer 8

Afib, Vfib, hypertension, dysrhythmias, hyperactive deep tendon reflexes, reduced motility, N/V, constipation, paralytic ileus when hypomagnesemia is severe

interventions: administer magnesium antacids, magnesium supplements,

Question 9

Sodium lab range

Answer 9

136-145

Question 10

Potassium lab range

Answer 10

3.5-5

Question 11

Calcium lab range

Answer 11

9-10.5

Question 12

Magnesium lab range

Answer 12

1.8-2.6

Question 13

Phosphorus lab range

Answer 13

3-4.5

Question 14

Best way to prevent infection for chemo pt

Answer 14

Avoid large crowds, wash hands

Question 15

TLS (tumor lysis syndrome)

Answer 15

Metabolic emergency where cell destruction occurs and K+ released into extracellular fluid.

Question 16

SIADH (Syndrome of inappropriate antidiuretic hormone)

Answer 16

S.I (saturated inside)
SIADH = impaired WATER RETENTION leading to hyponatremia

Question 17

Stomatitis

Answer 17

Inflammation in oral cavity. Magic mouthwash

Question 18

Types of surgeries:
Curative
Preventative (prophylactic)
Palliative

Answer 18

Curative: ex. removal of cancerous tumor
Preventative: ex. mastectomy
Palliative: managing s/s

Question 19

Cancer CAUTION acronym

Answer 19

Change bowel/bladder
A sore not healing
Unusual bleeding/discharge in stool
Thickening/lump in breast/testicles/elsewhere
Indigestion/dysphagia
Obvious change in size of mole/mouth sore
Nagging cough/hoarseness

Question 20

Chemo side effects

Answer 20

Infection, neutropenia, bone marrow suppression, alopecia, mucositis, dysphagia, diarrhea, fatigue, bleeding

Question 21

Primary, secondary, tertiary preventions

Answer 21

Primary: vaccines, health counseling, sunscreen, diet, exercise, safe sex, smoking, alcohol
Secondary: prevention, such as family history of breast cancer. Genetic screening/testing is wanted.
Tertiary: chemo-protective agents, Aspirin, NSAID’s

Question 22

TNM (tumor, node, metastasis

Answer 22

Tumor size 0-4, node felt or not 0-3, is it metastazied 0-1