final exam review Flashcards
(261 cards)
1
Q
ADHD shows brain characteristics where there may be a deficit in….
A
catecholamines, dopamine, and norepinephrine
2
Q
Clinical manifestations of ADHD are…
A
hyperactivity, impulsivity, lack of attention
difficulty completing tasks
decreased attention span
increased motor activity (cant sit still)
3
Q
ADHD is guided by the….
How long must symptoms be present for before being diagnosed?
A
- -DSM-5
- - >6 months
4
Q
What is a non-stimulant med that can be given to a child?
A
atomoxetine
5
Q
What observation may be seen if atomoxetine is working?
A
Able to sit still >15 minutes within 1st 10 days.
6
Q
What instructions would be given when using the daytrana skin patch?
A
Alternate between left and right hip
can cause leukoderma in kids
REMOVE after 9 hours
7
Q
If a child is prescribed adderral what should be monitored?
A
growth
8
Q
This condition is characterized by and extra chromosome called trisomy 21….
A
Down syndrome
9
Q
What are two common risk factors for Down syndrome?
A
maternal age >35
Paternal age >55
10
Q
What are the common clinical manifestations seen in down syndrome?
A
- -short legs and arms
- -hypotonia
- -protruding abdomen
- -epicanthal folds
- -reduced muscle tone
- -protruding tongue
- -short broad neck
11
Q
What are two non-pharm treatments for down syndrome?
A
- -cool mist humidifier
- -clear nasal passages with bulb syringe
12
Q
What two nutrition interventions would be done on a patient with down syndrome?
A
- -increase fiber
- -monitor calories
13
Q
This syndrome is when an infant falls below the 5th percentile for weight and height?
A
Failure to thrive
14
Q
What are some clinical manifestations of failure to thrive?
A
- -minimal smiling
- -poor eye contact
- -lack anticipated stranger danger
- -withdrawn
15
Q
With FTT, what should the nurse educate the parents on?
A
- -respond to hunger cues
- -provide stimulation
- -nurture child
- -proper positioning/latching when BF
16
Q
What will nutrition interventions be for a child with FTT?
A
–high calorie milk supplements
–multivitamin including zinc, and iron
–limit juice to 4oz a day
–dont force infant to eat
Home health nurse will visit and see how baby eats
17
Q
What chronic condition affects body movement, coordination, and posture?
A
Cerebral palsy
18
Q
Spastic CP is the most common type. What are the clinical manifestations associated with it?
A
- -stiff and jerky
- -increased muscle tone
- -rigid
19
Q
This form of CP has uncontrolled movements that affects basal ganglia
A
Dyskinetic
20
Q
This type of motor function in CP is manifested by a damaged cerebellum with poor balance and coordination.
A
Ataxia
21
Q
- -To help prevent CP in a child. What vaccine should the mother be up to date on?
- -What can it prevent?
A
- -Hemophilis influenza
- -bacterial meningitis
22
Q
What are some clinical manifestations of CP?
A
- -abnormal muscle tone
- -exaggerated DTR
- > 6 months old may be arching back or cant sit up
- -strabismus
- -nystagmus
- -hypertonia
- -scissoring/crossing legs without intention
- -excessive drooling
23
Q
In a patient with CP this med can be given for nerve pain and seizures.
A
gabapentin
24
Q
What other meds can be given for CP?
A
- -baclofen
- -benzos (valium)
- -GI symptoms (cimetidine/ranitidine)
25
What injection can be used in conjunction with a stretching program, in a patient with CP?
BT-A
26
What would the nutrition plan be for a pt. with CP?
- -high calorie 24kcal/oz of formula
| - -use utensils with padded handles
27
What may a child with suspected CP show before preschool years?
hand dominance
28
What disorder is characterized by impaired imaginative/collaborative play prior to 3 years old?
Autism Spectrum Disorder
29
What are three core characteristics of a pt. with autism?
- -social interactions
- -language impairment
- -repetitive behaviors
30
What clinical manifestations will a patient with Autism present with?
- -stereotypy (rigid or obsessive behaviors)
- -head banging
- -flapping hands/arms
- -rapid mood change
- -twirling in circles
- -biting themselves
31
A pt. with autism will have absence of ____ by age 1.
babbling
32
A pt. with autism will have an absence of two word sentence by age___
2
33
An autistic patient will use ____ instead of ___.
you
| I
34
An autistic person will engage in echolalia and is fascinated with.....
rhythmic, repetitive songs or verses
35
What are some pharm. therapies for a patient with autism?
- -SSRI's (fluoxetine)
- -antipsychotic (risperidone)
- -melatonin (insomnia)
36
What are nutrition interventions for a patient with Autism?
- -Vit. A, B6, and C
- -gluten free (wheat, barley, rye)
- -casein free (milk, eggs, cheese)
37
What are some red flags to look for when suspecting autism in an infant/toddler?
- -no babbling/communication by 12 months
- -no single words by 16 months
- -no 2 word sentences by 2 years
38
What are some presumptive signs of pregnancy?
- -breast changes
- -quickening
- -N/V
- -amenorrhea
39
What are some probable signs of pregnancy?
- -hegars, chadwicks, or goodells sign
- -braxton hicks contractions
- -positive pregnancy test
40
What are some positive signs of pregnancy?
- -fetal heart sound
- -fetal ultrasound
- -fetal movement
41
How to calculate due date?
1st day of last period + 7 days - 3 months + 1 year
42
A woman with normal pre-pregnancy weight can gain....
25-35 lbs
43
A woman who is overweight pre-pregnancy can gain....
15-25 lbs
44
A woman who is obese pre-pregnancy can gain...
11-20lbs
45
A woman who is underweight pre-pregnancy can gain...
28-40 lbs
46
What does oxytocin do?
dilates the cervix and can be used to stop bleeding
47
What is misoprostol used for?
softens cervix and stops bleeding
48
What can be given to stop contractions in a patient?
magnesium sulfate
49
What is the antidote for magnesium toxicity?
calcium gluconate
50
Describe the latent phase of labor.
- -0-3 cm dilated
- -contractions irregular, mild to moderate
- -occurs every 5-30 min
51
Describe the active phase of labor.
- -4-7 cm dilated
- -contractions regular, moderate to strong
- -every 3-5 min
- -monitor FHR q30 min, q15 if high risk
- -make sure mom voids to avoid damage to bladder
52
Describe the transition phase of labor
10 cm dilated
- -contractions strong q2-3 min
- -mom may feel out of control and have urge to push
- -Assess FHR q15 min, q5 if high risk
53
If patient has late decelerations the nurse would...
- -dc oxytocin
- -put mom on non-rebreather at 10-15L
- -lower bed, lay on side
54
If patient has lateral displacement of fundus, what should the nurse have the patient do?
go pee
55
If fundus is soft and boggy, the nurse will....
massage fundus in circular motion
56
When giving vitamin K to newborn, what gauge needle is used?
Where would it be given?
How much should be given?
- -25-27 gauge
- -vastus lateralis
- -0.5-1.0 mg
57
What is rooting?
stroke cheek= turn head
58
What is moro/startle reflex?
loud noise = jerky reflex
59
The APGAR score is done at....
1 minute and 5 minutes
60
What does APGAR stand for?
- -Activity
- -Pulse
- -Grimace
- -Appearance
- -Respirations
61
What is a Type 1 hypersensitivity response?
| What are some examples?
allergic response
| Examples are: HYPOTENSION, asthma, hay fever, food allergies
62
What is a type II allergic response?
| What are some examples?
--cytotoxic hypersensitivity
| Examples are: transfusion reaction, Rh mom
63
What is a type IV reaction?
| What are some examples?
- -delayed reaction
| - -Contact dermatitis, TB test, organ transplant
64
With type I reaction what would be the MAIN PRIORITY?
airway
65
What does the indirect Coombs test detect?
presence of circulating antibodies against RBC's
66
What does the direct Coombs test?
detects antibodies on RBC's
67
What is a chronic, progressive disorder that causes inflammation of tissue and organs, primarily in the joints?
Rheumatoid arthritis
68
What are some clinical manifestations of RA?
- -has remissions and exacerbations
- -occurs after prolonged inactivity
- -lasts > 1 hour
- -appears red, hot, and swollen
- -symmetrical, multiple joints affected
- -morning stiffness
- -ulnar deviation, swan neck, boutonnieres deformities
69
This type of arthritis affects the knees, ankles, and elbows.
Pauciarticular arthritis
70
This type of arthritis affects multiple joints and internal organs and may present with fever, and rheumatoid rash.
Systemic arthritis
71
What drugs can be used for Rheumatoid arthritis?
- -NSAIDS
- -Corticosteroids
- -DMARDS (methotrexate)
72
What non-pharm tx. can be used for RA?
- -alternate heat and cold packs
- -moist heat (most effective)
- -dip hands in paraffin bath
73
Autoimmune disorder that causes destruction to healthy tissue that can have remissions and exacerbations
SLE
74
DLE affects the....
skin
75
SLE affects the....
connective tissue (lead to organ failure)
76
MILE is caused by....
Meds.
| Usually gets better when stop the meds
77
What are clinical manifestations of Lupus?
- -Raynauds phenomenon
- -butterfly rash over nose and cheeks
- -alopecia
- -sun sensitivity
- -friction rub when listening to heart
78
In Lupus, C3-C4 will be_____
| ESR will be _____
- -decreased
| - -increased
79
What are some pharm tx.'s for Lupus?
- -NSAIDS
- -Corticosteroids
- -Immunosuppressants (methotrexate)
- -antimalarial (hydroxychloriquine)
80
Oral contraceptives in a pt. With lupus increases the risk of....
lupus exacerbation
81
Stage 1, progression of HIV is represented by a CD4+ and t lymph count of....
500
82
Stage 2, chronic asymptomatic infection is represented by a CD4+ and t lymph count of...
200-499
83
Stage 3, AIDS caused by HIV is represented by a CD4+ and t lymph count of...
<200
84
HIV meds are safe to take during____
Pregnancy. Should be continued to decrease risk of transmission to fetus
85
What are the clinical manifestations of HIV?
- -fever
- -sore throat
- -headache
- -rash
- -nausea
- -weight loss
- -arthralgia, myalgia
86
What diet would a person with HIV be recommended?
high protein, and calorie
87
What are early signs of shock?
- -oriented
- -restless
- -anxiety
- -increase pulse
- -reduced BP
88
What are intermediate signs of shock?
- -reduced sensory perception
- -slowed speech
- -cool moist skin
- -rapid/shallow respirations
- -pale
- -oliguria
- -weak, thready pulse
- -low BP
89
What are late signs of shock?
- -reduced LOC
- -cyanosis
- -bradycardia
- -cool moist skin
- -labored resp.
- -anuria
- -BP continuing to drop
90
What will the nursing intervention be if someone has shock?
- -Replace volume (give LR)
- -Give vasopressor, monitor BP
- -Protect airway (O2 or intubate)
91
What CN's are sensory?
1,2,8
92
What is the normal ICP measurement?
0-15
93
Dysfunction of ICR is due to...
- -impaired perfusion
- -reduced oxygenation
- -reduced glucose
94
Late signs of IICP involve the cushings triad. What is the cushings triad?
- -bradycardia
- -hypertension
- -bradypnea
95
Someone presenting with IICP is an emergency. What should be the nurses actions?
- -maintain airway
- -elevate HOB 30 degrees(neck aligned)
- -seizure precaution
- -give mannitol (osmotic diuretic)
- -monitor VS (maintain adequate CO)
- -sedate patient, dim lights, limit visitors, control fever)
96
Meds for IICP are?
- -mannitol
- -phenytoin (seizures)
- -dexamethasone (edema)
- -acetaminophen
97
If a patient has IICP what diagnostic should NOT be performed?
lumbar puncture
98
What procedure can be done to relieve hydrocephalus in a child with IICP?
VP shunt
99
If a 12 year old patient presents with IICP, the nurse will instruct the parents to notify the physician if...
decreased LOC
100
What type of burn is a sunburn?
superficial thickness
101
If a patient presents with hypothermia, the nurse will...
- -provide blankets
| - -heat lamp
102
If a burn covers > 25% of TBSA it is considered a...
major burn
103
If body is burned <15% of TBSA it is considered a...
minor burn
104
If body is burned 15-25% of TBSA it is considered a...
moderate burn
105
The emergent phase of a burn begins with the injury and continues for 24-48 hours, what would be the nursing process?
- - Secure airway, NG tube (if burns >20% of TBSA)
- -replace fluids (LR)
- -prevent infection
- -maintain body temp
- -give morphine/fentanyl
106
The acute phase of a burn begins 48-72 hours after injury, what is the nursing priority?
- -NPO
- -assess/monitor cardiac, respiratory, GI system
- -wound care
- -pain management
- -psychosocial interventions
107
The rehabilitative phase after a burn can last many years. The nursing priority is...
--psychosocial support, prevent scars and contractures, resume activities (work, family, social life)
108
What are signs of heat exhaustion?
- -fatigue, light headed
- -N/V/D
- -impending doom
109
What nursing interventions would be done for a person with heat exhaustion?
- -cool area, remove clothes
- -give oral/IV NS
- -monitor airway
110
A heat stroke is an emergency. What are signs of heat stroke?
- -reduced LOC
- -hot, dry, ashen skin (no sweat)
- -loss of muscle coordination
- -temp. >105 degrees
111
What will the nursing interventions be for a patient with heat stroke?
- -cool area, remove clothes, ice packs, cool blankets, cool saline, peritoneal dialysis
- -100% O2
- -give diazepam (reduce shivering)
112
What temp would mild hypothermia fall under?
89.6-95
113
What temp would moderate hypothermia fall under?
82.4-89.6
114
What temp would severe hypothermia fall under?
<82.4
115
If a person has frostbite the nurse will...
immerse in warm water for 20-30 min, do not massage/rub
116
What is pink frothy sputum a sign of?
Pulmonary edema
117
What medicinal treatment is used for someone exposed to anthrax?
cirpo/penicillin
118
Smallpox is what type of precaution?
| Botulism?
- -droplet
| - -standard
119
What organization ensures clinicians have updated info and acts as two way communication with the CDC?
COCA
120
A client with an electrical burn is classified as having a...
major burn
121
---during the initial burn phase what lab will nurse suspect to be elevated?
hct
122
external rewarming involves...
- -warm bath
- -radiating heat
- -forced warm air
123
A client experiencing early signs of hypovolemic shock will have...
- -slight increase in pulse
- -slight decrease in BP
- -normal respirations
124
A form of sex therapy touching each others body parts is?
sensate therapy
125
a female patient has been trying to get pregnant for the past 2 years, what can cause the woman to not concieve?
- -alcohol consumption
- -amount of exercise
- -poor nutrition
- -STI's
126
what is clomid?
--stimulates luteinizing hormone
127
what type of HRT can be used in menopause?
--low dose vaginal estrogen
128
surgical menopause can be treated with
--HRT
129
what are some clinical manifestations of menopause?
- -vaginal dryness
- -dyspareunia (painful sex)
- -hot flashes
- -urinary stress incontinence
130
what are the two labs that rise and remain elevated with menopause?
--FSH and LH
131
clinical manifestations of primary dysmenorrhea are
- -pelvic pain radiating to groin
- -N/V/D
- -fatigue
- -breast tenderness
132
what is menometrorrhagia?
--irregular excessive prolonged period
133
what should a female patient do if she is experiencing post menopausal bleeding?
--seek medical attention
134
what is an example of a COC?
depo-provera
135
what meds can be given for a female with heavy bleeding?
- -estrogen
- -medroxyprogesterone
- -iron
136
what vitamin helps with dysmenorrhea?
B12
137
what would the nurse include in the plan of care for a patient with ED due to a chronic condition?
- -explain meds being prescribed
| - -explain devices and surgeries available
138
What oral meds can be given to a pt. with ED?
- -viagra
- -cialis
- -levitra
139
The nurse should inform a patient taking drugs for ED to refrain from taking....
- -aplha blockers
| - -nitrate based drugs
140
Females have a higher risk for what STI's?
gonorrhea, chlamydia
141
This STI can present with white patches in the mouth, cloudy discharge from vagina or penis...
chlamydia
142
This type of syphilis presents with papules on labia, anus, or corner of the mouth...
Secondary syphilis
143
This type of syphilis presents with pock marks (holes) in skin...
Tertiary "late stage" syphillis
144
A diaphragm is used with a spermicidal cream/jelly. How long after sex should it be left in place?
6 hours
145
What med can cause a clinical interruption of pregnancy when a woman has decided on an abortion up to 49 days following conception?
Mifepristone
146
What type of eye disorder is the most common cause of blindness in the elderly?
Macular degeneration (MD)
147
What kind of stroke occurs when blood clot cuts off circulation to the heart?
ischemic
148
When giving eye drops the nurse must be sure to apply...
pressure during and after administration
149
To be able to drive after cataracts surgery the patient must be able to...
score above a certain level on acuity test to be able to drive
150
If a patient has a burn to the eye the nurse will...
- -flush eye with NS for 30 min
| - -apply antibiotic ointment
151
A patient with myopia may present with...
- -headaches
- -difficulty reading
- -poor school performance (cant see board)
152
What is esotropia?
deviation inwards
153
what is exotropia?
deviation outwards
154
What is hypertropia?
deviation upwards
155
What is hypotropia?
deviation downward
156
What is cataracts?
Gradual clouding of lens that affects ability to perceive images clearly
157
What are some characteristics of a person with cataracts?
* *cloudy, opaque lens
* *reduced visual acuity
* *reduced night vision
- -blurry vision
- -loss of red discrimination
158
What meds prevent pupil constriction and is usually given during an eye exam? What would we teach the pt.?
1% atropine
| --effects may last 7-12 days, wear sunglasses to protect eyes
159
What condition presents with the gradual loss of peripheral vision and increased intraocular pressure?
Glaucoma
160
What is the difference between Primary open angle and angle closure glaucoma?
```
Primary Open angle (gradual)
Angle closure (Acute) and emergent
```
161
What are the clinical manifestations of a person with open angle glaucoma?
- -gradual
- -tunnel vision (loss of peripheral vision)
- -halos
- -elevated IOP (>21 mmHg)
162
What are the clinical manifestations of a person who has angle closure glaucoma?
- -acute
- -IOP (>30mmHg)
- -reddening of eyes
- -halos
- -severe pain
- -dilated pupils
163
What meds can be given for glaucoma?
- -timolol (beta blocker)
- -alphagan (alpha2 adrenergic agonist)
- -diamox (carbonic anhydrase inhibitors)
- -Pilocarpine (cholenergic agonist)
164
What drug can be used in the emergency treatment of closed angle glaucoma?
Mannitol
165
What are clinical manifestations of Macular degeneration (MD)?
- -loss of central vision
- -vision distortion
- -colors seem more dull
- -blurred vision/blind spots
166
What drug is useful in treating wet MD?
antiangiogenic drugs (lucentis)
167
What should nurse teach for patient with MD?
- -Use assistive devices (large print books, magnifying glass)
- -teach patient to rely on peripheral vision
168
If a patient has tinnitus they may experience...
buzzing, roaring, ringing in ears
169
When examining the ears on an adult/child how will the nurse pull the pinna?
Adult- up and back
| child- down and back
170
The tympanic membrane should look...
pearly, grey and intact
171
If a patient is experiencing sensironeural hearing loss what treatment would be done?
cochlear implant
172
What is conductive hearing loss?
same loss in both ears
173
What is conduction sound?
all sound frequencies
174
What should be documented in the blood transfusion record?
- -Blood type
- -Rh factor
- -Blood band number
- -exp. date
175
What are the signs and symptoms of anemia?
- -weakness
- -pallor
- -fatigue
176
How would anemia be treated?
- -Give O2
- -Give erythropoeitin
- -Put up HOB
- -rest
- -keep pt. warm
- -Give vitamin B12, iron, folic acid
- -give PRBC's if needed
177
What is the top priority with an anemic patient?
- -oxygenation
- -perfusion
- -nutrition
178
What are signs of a pulmonary embolism?
- -dyspnea
- -tachypnea
- -impending doom
- -jugular vein distention
- -restlessness
- -cyanosis
179
What are the nursing interventions for a pulmonary embolism?
- -Give 500-1000 mL of fluid
- -give vasopressor (epinephrine)
- -give anticoagulants
- -elevate legs
180
A patient who has had a hemorrhagic stroke has become more drowsy during the day, what should the nurse do next?
--call provider
181
A client is recovering from cataracts surgery, what statement shows the clients understanding of home instructions after the surgery?
Cook dinner the night after surgery
182
A client is in the unit for 2 days and is experiencing auditory hallucinations, what could this be caused by?
- -sensory overload (too much stimuli)
| - -sleep deprivation
183
If a person is experiencing an acute MI, what will the 12 lead EKG changes show?
- -ST seg elevation
- -enlarged Q waves in lead 2 and 3
- -VF
184
A client is recovering from cataract surgery, what can indicate an onset of retinal detachment?
- -flashing lights
| - -partial loss of visual field
185
What is a common med that can be given for CAD?
What should the nurse monitor?
What may this med interfere with?
- -statins
- -liver enzymes
- -coumadin
186
What med can be given for angina (heart pain)?
How much can be taken?
What should not be taken with it?
- -Nitro
- -every 5min, max 3 times(call 911 if pain persists)
- -ED meds (cialis, viagra)
187
What will the EKG look like with a STEMI?
ST elevation (near complete blockage= death)
188
What will an EKG look like with an NSTEMI?
| What is our concern when we see this?
- -ST depression or inverted T-wave
| - -Cardiac arrest
189
What are clinical manifestations of a MI?
- -dull, substernal crushing pain
- -tightness in chest
- -dyspnea
- -low BP
- -High HR
- -N/V
- -denial
190
What does the acronym MONA stand for when treating an MI?
- -Morphine
- -Oxygen
- -Nitro
- -Aspirin
191
What will a normal sinus rhythm show?
- -RR interval: regular
- -Rate: 60-100 bpm
- -P wave: upright, one per each QRS
- -PR interval: 0.12-0.20 seconds
- -QRS interval: <0.12 seconds
192
If a person is showing signs of sinus bradycardia what tx. can be done?
--atropine 0.5-1.0 mg IVP
193
What ECG wave shows a saw tooth like wave?
Atrial flutter
194
What type of ECG wave shows an irregular "quivering" baseline pattern.
A-fib
195
A person with an Idoiventricular rhythm will show signs of no p-wave, wide QRS, and a rate of about 20-40 bpm. What is the nurses priority?
- -Initiate CPR if no pulse
- -Restore volume
- -give atropine, dopamine (give pacemaker if not responding to meds)
196
This EKG wave shows a non measurable PR interval with wide and bizarre QRS waves due to the lower chambers of the heart beating very quickly. What is it and what is the tx.?
- -V-tach
- -give Amiodarone, K+, and mag.
- -Pulse: cardiovert
- -Pulseless: defibrillate/CPR
197
What life threatening ECG wave shows the ventricles quivering uselessly instead of pumping blood?
V-fib
198
In cellular regulation, what is the term used for an error that cannot be repaired?
apoptosis
199
What is the difference between a benign and malignant tumor?
--Benign: local, cohesive, well defined borders, slow growth, pushes other tissue out of way, easily removed, does not recur
--malignant: invasive, non-cohesive, crosses tissue border, invades and destroys other tissue, rapid growth, not always easy to remove, can recur
200
What do malignant cells need to grow?
blood source for nutrients
201
One major indicator of cancer is if a patient comes in with this type condition and has never had it before or it is getting worse. What is the condition?
anemia
202
What are common symptoms of leukemia?
- -weight loss/loss of appetite
- -SOB
- -weakness/fatigue
- -bone/joint pain
- -swollen lymph nodes
- -night sweats, easy bleeding/bruising, purple spots
203
What are common clinical manifestations of cancer?
- -anemia
- -infection
- -anorexia (cachexia syndrome)
- -paraneoplastic syndrome (altered immune response)
- -pain (late sign)
- -stress
204
What type of isolation precautions would be used in a patient with cancer receiving chemo?
What should the nurse consider with this precaution?
- -reverse isolation (neutropenic precautions)
- -no flowers, visitors, fresh fruits/veggies
- -avoid invasive procedures
- -keep dedicated equipment in room
205
What are some examples of primary prevention for cancer?
- -dont smoke
- -exercise
- -sunscreen/limit sun exposure
- -balanced diet
- -BRCA 1 (prophylactic surgery)
206
What are some secondary preventions for cancer ?
- -colonoscopy
- -mammogram
- -Pap smear
- -Guaic testing (blood in stool)
- -prostate specific antigen (PSA)
207
What are some collaborative interventions for cancer?
- -Surgery
- -radiation
- -chemo
- -hormone, targeted, or biologic therapy
- -bone marrow transplant
208
What are three common therapies for cancer?
- -Surgery
- -radiation
- -chemotherapy
209
What can BRCA 1 and BRCA 2 genetic testing detect?
Breast cancer
210
This stage of prostate cancer is confined to the prostate, non-palpable and well differentiated.
Stage 1
211
What treatment can be done in stage 1 of cancer?
- -observation
- -beam radiation
- -prostatectomy
212
What stage of prostate cancer is characterized by palpable, poorly differentiated area that is confined to the prostate?
Stage 2
213
What is the treatment for stage 2 prostate cancer?
- -observation
- -prostatectomy
- -beam radiation
- -cryosurgery
214
What stage of prostate cancer shows an extension of the tumor outside of the prostate?
Stage 3
215
What treatments can be used on someone with stage 3 prostate cancer?
- -beam/interstitial radiation
- -Radical prostatectomy
- -hormone therapy
- -Palliative surgery (TURP)
216
What stage of prostate cancer is characterized by an extension of the tumor into surrounding tissues, lymph node involvement, and distant metastasis?
Stage 4
217
What are some tx.'s for stage 4 prostate cancer?
- -hormone therapy
- -beam radiation
- -radiation/TURP therapy
- -radical prostatectomy with orchiectomy
- -chemo
218
What is the TNM staging system for cancer and what do the letters stand for?
used to stage cancer. The lower the number the better the prognosis.
- -Tumor
- -Node
- -Metastasis
219
Myocardial ischemia can be caused by a build up of...
lactic acid
220
At how many hours does creatine Kinase peak?
18
221
During an assessment of a pt. with anemia, what specific information should the nurse ask the patient about?
Stomach surgery
222
A patient with hypovolemic shock is receiving LR for fluid replacement. What specific lab should the nurse monitor?
Serum pH
223
By keeping the temp in the room warm, and wrapping the newborn in a blanket the nurse is preventing what heat loss?
Convection
224
What are some effects of chemo toxicity?
- -neuropathy
- -fatigue
- -alopecia
225
If a patient is admitted to the burn unit, what would delay hydrotherapy?
attempting to neutralize the burn
226
A patient has superficial partial thickness burns. What would the nurse expect to find?
fluid filled blisters
227
A nurse assesses that a client has sensory impairment from long term use of furosemide. Which actions will the nurse implement?
when communicating with the client, use lower tone of voice
228
A client diagnosed with a stroke is going to receive treatment with fibronolytic therapy using the rt-PA. Which information should the nurse include when performing medication teaching for the clients family?
given to break up existing clots and increase cerebral blood flow
229
What vitamins can help slow dry Macular degeneration?
vitamins C, zinc, and beta carotene
230
What are the oncofetal antigen tumor markers for lung and breast cancer?
CEA
231
What is the specific protein tumor marker for adenocarcinoma of the prostate?
PSA
232
What protein tumor markers are associated with breast cancer?
- -CA 15-3
- -CA 27-29
- -EGFR
- -HER1
- -HER2
233
What protein tumor marker is associated with lung cancer?
EGFR
234
If a patient with cancer is having trouble maintaining good nutrition, what are some things the nurse can educate the pt. on?
- -eat whatever is appealing (something is better than nothing)
- -drink ensure, isocal, or protein powders
- -eat small, frequent meals
- -try icy cold foods (i.e. ice cream)
- -numb mouth with lidocaine if have ulcers to make eating easier
- -remove foods/odors that induce vomiting. Take antiemetic before meals to reduce N/V
- -keep a food diary
235
What are antineoplastic alkylating agents used for?
kills fast growing cancer cells by altering DNA structure and preventing cell reproduction
236
What are examples of alkylating agents?
- -cyclophosphamide
- -carboplatin
- -chlorambucil
237
Antineoplastics are vesicants, How should they be administered?
central line
238
What labs should the nurse monitor when taking an alkylating agent like cyclophosphamide?
- -WBC
- -platelet
- -H & H (RBC's)
- -neutrophils
239
What should the nurse advise the client about alopecia when it comes to taking alkylating agents?
- -Hair loss may occur 7-10 days after taking meds and will last about 2 months
- -advise clients who want to do so, to select hairpiece prior to starting treatment
240
What do antitumor antibiotics do?
kills cancer cells by stopping synthesis of RNA, DNA, or proteins
241
What do antimetabolites do?
kill cancer cells by interrupting S-phase
242
what are some examples of antimetabolites?
cytarabine, fluoracil, methotrexate
243
Methotrexate is a Pregnancy risk category X drug. What should the nurse should advise the patient on when taking this drug?
- -do not become pregnant while taking it, or 6 months after stopping it.
- -encourage use of Birth control
244
What meds can be given for aggressive cancers?
Vinca alkaloids
- -vinblastine
- -vincristine
245
What two meds classes are major contributors to chemo toxicity?
antimetabolics
| antitumor antibiotics
246
Due to bone marrow suppression the patient is at increased risk for...
bleeding and infection
247
What is nadir and how long does it usually last?
lowest blood count after chemo
| lasts 7-10 days
248
What can be given in a patient with bone marrow suppression to treat anemia?
epogen
249
What is tumor lysis syndrome and what labs should be monitored?
- -caused by rapid tumor cell breakdown after therapy causing kidneys to work extra hard to remove substances in tumors. If the kidneys cant keep up, TLS develops
- -monitor BUN, creatinine, and electrolytes
250
What would the electrolyte labs look like in a person with TLS?
- -high potassium, phosphate
| - -low calcium
251
What drugs are major contributors to TLS?
- -cisplatin
- -methotrexate
- -mitomycin
252
How would the nurse manage TLS?
- -giving bicarbs, and allopurinol (prevent renal failure)
- -may need dialysis
- -kayexalate, hypertonic dextrose and insulin (restore electrolytes)
- -phosphate binding gels (decrease phosphorus)
253
What two antitumor antibiotic drugs are major contributors to reducing lung function causing pulmonary fibrosis?
- -bleomycin
| - -daunorubicin
254
What cancer treatment drug is responsible for causing peripheral neuropathy?
cisplatin (assess for neuropathy)
255
What are the two diagnostic tests done to biopsy for diagnosis?
- -needle aspiration biopsy
| - -excisional biopsy (cut)
256
If a cure for cancer is not an option, maintaining quality of life is important. What procedure can be done to ease the passage of food?
stent
257
What two procedures can be done to remove extra fluid in a person with cacner?
- -thoracentesis
| - -chest tube
258
If a person were to undergo external radiation, what are they at risk for?
skin breakdown
259
If a patient has impaired skin integrity due to external radiation, what are some things the nurse can educate the pt on?
- -don't use powders, lotions, soaps, deodorant
- -avoid rubbing/scratching area
- -avoid sun
- -wear cotton clothes (no binding clothes)
- -apply zinc containing ointment to area
260
What are some side effects of radiation toxicity?
- -malaise
- -fatigue
- -anorexia
- -anemia
261
What should the nurse be monitoring with all cancer pts.?
- -VS (infection/bleeding)
- -mucous membranes
- -skin
- -hair loss
- -weight
- -pain (may indicate progression)
- -fatigue (from cancer tx)
- -psychological status (do they have hope?)
- -body image (mastectomy, hysterectomy)
- -support system
