Exam 4 Blueprint

Question 1

What are risk factors for cancer?

Answer 1

age, immunosuppression, race, genetic disposition, chemicals/tobacco/alcohol, exposure to viruses and bacteria, diet, sun/radiation exposure, sexual lifestyles, poverty/obesity/chronic gerd, chronic disease, air pollution

Question 2

What does primary cancer prevention mean?

Answer 2

-using preventative measures to prevent cancer occurrence

Question 3

Examples of primary cancer interventions?

Answer 3

-discontinuing tobacco
-breathing clean air
-diet high in fruits, veggies, complex carbs
-control weight
-reduce fat intake
-stay out of sun during peak hours and use sunscreen
-wear protective equipment

Question 4

Tamoxifen has shown to reduce the risk of _____ cancer in high risk individuals ?

Answer 4

breast cancer

Question 5

NSAID use is investigational and may reduce the risk for what type of cancer?

Answer 5

colorectal

Question 6

What vitamins and plant derivatives have shown in clinical trials they may reduce risk of cancer?

Answer 6

-soy products
-tea and herbs
-vitamins ABCDE and more

Question 7

What are secondary cancer prevention strategies?

Answer 7

use of screening strategies to detect cancer early

Question 8

Examples of secondary cancer prevention?

Answer 8

Self examination
mammograms
PSA

Question 9

What areas of the body should we be teaching our patients to self-examine to identify cancer?

Answer 9

skin
oral cavity
lymph nodes
breasts or chest walls
testicles/ penis

Question 10

What is the ‘CAUTION’ acronym for signs and symptoms of cancer?

Answer 10

-change in bowel or bladder habits
-A sore that does not heal
-unusual bleeding or discharge
-thickening or a lump in breast or else where
-indigestion or difficulty swallowing
-obvious change in wart or mole
-nagging cough or hoarseness

Question 11

What is tertiary prevention of cancer?

Answer 11

a set of measures that aim to reduce complications and progression of cancer In those that have been already diagnosed

Question 12

What are the methods of tertiary prevention?

Answer 12

-surgical tx
-radiation
-chemotherapy
-bone marrow transplants
-hyperthermia
-biologic response modifiers

Question 13

Review Bladder/lung/breat/skin/prostate

Answer 13

• on page 382 in IGGY book

Question 14

What can be used to diagnosis cancer?

Answer 14

-history and physical exam
-blood and urine tests
-diagnostic imaging
-biopsies

Question 15

What is osteoporosis?

Answer 15

chronic metabolic disease causing bone loss/decreased bone density

Question 16

The first sign of osteoporosis is often?

Answer 16

a fracture

Question 17

What bones are most likely to be affected in osteoporosis?

Answer 17

spine, hip, and wrist

Question 18

What is primary osteoporosis?

Answer 18

-caused by losing testosterone and estrogen in older age

Question 19

what is secondary osteoporosis?

Answer 19

-may result from other medical conditions, long-term drug therapy or prolonged immobility

Question 20

What is a dexa scan?

Answer 20

the best tool to dx osteoporosis ; assesses bone density via x-ray

Question 21

When should women begin getting DEXA scans

Answer 21

above age 40

Question 22

What is BMD? What diagnostic test evaluates this?

Answer 22

-bone mineral density
-DEXA scan

Question 23

What is a T-score

Answer 23

represents the number of standard deviations above or below the BMD

Question 24

What BMD t-score is positive for osteopenia ?

Answer 24

-1 to -2.5

Question 25

What BMD t-score is positive for osteoporosis?

Answer 25

< 2.5

Question 26

Our goal BMD t-score is ?

Answer 26

to be above -1

Question 27

What is a z-score?

Answer 27

compares BMI with your age group, BMI, and same sex

Question 28

A z-score is most commonly used when ?

Answer 28

-premenopausal women -men less than age 50 -children

Question 29

An abnormal z-score is used to diagnose primary or secondary osteoporosis?

Answer 29

secondary

Question 30

A z-score of -1.5 and above indicates

Answer 30

typical bone density for age group

Question 31

A z-score of less than -1.5 indicates

Answer 31

atypical BMD

Question 32

What supplements should be taken with osteoporosis and osteopenia to increase bone density?

Answer 32

calcium and vitamin d

Question 33

Calcium and vitamin d nursing considerations?

Answer 33

-give in divided doses with 6-8 oz of water -increase fluids to prevent renal calculi -s/s of hypercalcemia -take with food to prevent gi upset

Question 34

Why should clients on calcium take a third of the daily dose at bedtime?

Answer 34

-no weight bearing activity occurs while sleeping

Question 35

What is the suffix for biphosphonates, given to help with osteopenia?

Answer 35

-dronate

Question 36

What education should we give patients on how to take bisphosphonates?

Answer 36

-take on an empty stomach first thing in the morning with a full glass of water -30 minutes before eating -sit up 30 minutes after taking to prevent esophagitis

Question 37

Why should patients have dental examinations before starting bisphosphonates

Answer 37

risk of jaw and maxillary osteoporosis especially if dental hygiene is poor

Question 38

If patients are sensitive to aspirin, why should they not be given a bisphosphonates

Answer 38

bronchconstriction may occur

Question 39

How does calcium help with osteoporosis?

Answer 39

calcium helps improve bone density

Question 40

How does vitamin D help prevent osteoporosis

Answer 40

helps the body absorb calcium which is needed to build healthy bones

Question 41

Method of action for bisphosphonates

Answer 41

they slow bone resorption (breaking down of bones)

Question 42

S/s of fractures?

Answer 42

-limited mobility -severe acute or persistent pain -altered sensory perception

Question 43

s/s specific to hip fractures?

Answer 43

-inability to move immediately after a fall -severe pain in hip or grain -inability to put weight on injured side -shorter leg on the side of injured hip -turning outward of leg on side of injured hip

Question 44

What is the treatment of choice for a fractured hip?

Answer 44

open reduction with internal fixation

Question 45

What type of traction may be applied before surgery for fractured hip

Answer 45

buck's traction

Question 46

In hip fractures of the femoral neck, what are we most concerned for

Answer 46

avascular necrosis ; reduced blood supply to the head of the femur leading to death of bone tissues and decreased mobility

Question 47

Preoperative care for hip fractures

Answer 47

-IV pain medication upon entering emergency department -temporary placement in skin traction -discontinue blood thinning medications

Question 48

Best practices for care of those with hip fractures

Answer 48

box 44.5 in Iggy textbook pg 1095

Question 49

What is the most common form of arthritis ?

Answer 49

osteoarthritis