Hematology/Oncology

Question 1

What is Thrombocytopenia

Answer 1

Low platelets

Question 2

Purpura

Answer 2

Reddish-Purple bloches underskin that do not blanch, indicating beeding underskin

Question 3

What is Thrombotic thrombocytopenia purpura and its S/S

Answer 3

Platelet disorder causing microthrombi to form in small blood vessels
- Hemolytic anemia (jaundice/pallor)
- Thrombocytopenia (petechiae, purpura)
- Fever
- Low platelet count
- Neuro Issues (confusion, seizure)
- renal failure
WATCH FOR brain bleed!

Question 4

Neutropenia

Answer 4

Low white blood cell count

Question 5

Virchows Triad

Answer 5

1. Altered blood flow (venoustasis)
2. Endothelial damage
3. Hypercoagulable state

Question 6

What is polycythemia Vera

Answer 6

When the body produces too many RBCs (WBC and platelets also), causing the blood to become sluggish leading to poor perfusion, and clotting. Common in COPD’ers due to lack of 02 causing body to over produce RBC

Question 7

What are the 4 types of anemia

Answer 7

1. Anemia: low HGB. (S/S: tacky, SOB, pallor, confused, dizzy, think not enough 02)
2. Megoblastic Anemia: due to b12/folic acid deficiency (vegans)
3. Iron deficiency anemia: d/t low iron
4. Sickle cell anemia: genetic disorder causing red blood cells to change shape and stick together.

Question 8

What are the complication of sickle cell anemia

Answer 8

1. Vaso occlusive crisis: large number of sickle cells clumping together and obstructing small blood vessels leading to pain crisis from ischemia
2. Splenic sequestration crisis: RBS get trapped in spleen causing splenomegaly and HOTN

Question 9

What steps should the nurse take if they suspect a tranfusion reatcion

Answer 9

1. Stop the infusion
2. Disconnect tubing
3. Infuse NS
4. Inform provider and bloodbank
5. VS
6. Recheck labels, numbers, and client blood type
7. Treat Symptoms
8. Collect Blood and Urine Samples
9. Return blood and tubing to blood bank
10. Complete paperwork and documentation

Question 10

Acute Hemolytic Transufion Reaction

Answer 10

Reaction from receiving incompatible blood.
S/S fever/chills, flank/back pain, dark red urine, tachycardia, HOTN, dyspnea.
Complications: DIC, AKI, Shock

Question 11

Anaphylactic Transfusion Reaction

Answer 11

Allergic reaction to RBC
S/S: resp distress, skin changes, abdominal pain, angioedema, HOTN, wheezing

Question 12

Febrile Nonhemolytic Transfusion Reaction

Answer 12

Most common reaction
S/S: fever/chills

Question 13

Hemophilia

Answer 13

Deficiency in coagulaiton proteins leading to issues with clotting and increased risk of uncontrolled bleeding.
Tx: IV clotting factors
NO NSAID

Question 14

Von Wildebrand

Answer 14

Deficiency of vWR causing a bleeding disorder
Tx: desmopressin

Question 15

What is teletherapy

Answer 15

External beam radition therapy.
Pt should:
- Avoid extremes in temp
- No sun
- Only use lotions approved by physician
- Shower daily
- No scratching or rubbing

Question 16

S/S and risk factors for Colorectal CA

Answer 16

S/S
- Rectal bleeding
- Changes in bowel habits
- Pain
- Screening is Key
- Anemia
Risk Factors
- Family Hx,
- IBD
- >50
- Diets/Lifestyle: high in red meat, not enough fiber, alcohol use, obesity, smoking, stationary

Question 17

S/S Prostate CA

Answer 17

S/S: urination issues, ED, fatigue

Question 18

Causes of Cervical CA

Answer 18

HPV and things that increase changes of getting HPV such as multiple partners, sex before 18, Hx of STDs, immunosuppression, oral contraceptive, living in poverty, tobacco

Question 19

Causes and S/S of Endometrial CA

Answer 19

S/S abnormal uterine bleeding, lower back pain, abdominal pain
Causes: Family Hx, prolonged exposure to estrogen without progesterone, PCOS, infertility, early menarche (period before 12), obesity, tamoxifen (estrogen chemo drug)

Question 20

S/S of Lymphoma

Answer 20

• drenching night sweats
• weight loss
• pruritus
• enlarged lymph nodes
• fever
• severe pain after alcohol

Question 21

Types of Lymphoma

Answer 21

Hodgkin: reed sternbery cells found in lymphatic tissue, typically one node involved
Non-Hodgkin: multiple lymph nodes involved. More common

Question 22

What is Tumor Lysis Syndrome

Answer 22

Electrolyte imbalance d/t cell lysis from cancer cell break down during chemo or immuno therapy. (think hyperkalemia, hypherphosphatemia.)

Question 23

What can Chemotherapy cause

Answer 23

Neutropenia, thrombocytopenia, and anemai

Question 24

What is Oral Muscositis

Answer 24

Inflammation of mouth d/t radiation of head or neck
S/S: dry mouth, no taste, hurts to swallow

Question 25

Side effects of Radiation

Answer 25

Affect areas with rapid cell growth (oral mucosa, GI, bone marrow) - N/V - diarrhea - low WBC

Question 26

Recovery from Masectomy

Answer 26

- Elevate arm to heart level (crucial to reduce fluid retention and preventing lymphaedema - Encourage hand and arm exercises - No trauma to affected arm, INCLUDING BP

Question 27

Symptoms of sickle cell anemia

Answer 27

- Increased reticulocyte count - Fever - Bone pain (occlusion, fracture, osteomyelitis) - Leukocytosis - Tachycardia

Question 28

Treatment for Lymphoma

Answer 28

Chemotherapy and radiation

Question 29

What is superior vena cava syndrome

Answer 29

When the SVC gets compressed by malignancy

Question 30

Transfusion Related Acute Lung Injury (TRALI)

Answer 30

From antibody reaction S/S Respiratory distress, non-cardiogenic pulmonary edema

Question 31

Transfusion Related Circulatory Overload (TACO)

Answer 31

Fluid overload, most common in pt with cardiovascular or renal disease S/S pulmoary edema, respiratory distress

Question 32

General Warning Signs of Cancer

Answer 32

CAUTION - Changes to bowel habits - A sore that does not heal - Unusual bleeding or discharge from a body orifice - Thickening or lump in the breast or elsewhere - Indigestion or difficulty swallowing - Obvious change to wart or mole - Nagging cough or hoarseness

Question 33

Neutropenic Precautions

Answer 33

1. Strict Hand Washing 2. Vitals q4h 3. Dedicated equipment 4. Reverse Iso 5. Shower BID with microbial soap 6. Avoid crowds 7. Private room 8. Limit staff/visitors 9. No fresh flowers 10. No raw fruits/veggies/undercooked meat 11. No pitcher of water 12. Check WBC daily 13. No indwelling catherters 14. Do not reuse diposable plates or cups

Question 34

How does tumor lysis syndrome cause kidney stones

Answer 34

1. DNA and RNA leaves cell and gets broken down to uric acid. High uric acid in the bloody will cause uric stones 2. Phosphorous is relased from cells and binds with calcium in blood causing phosphorus/calcium stones (also hypocalcemia)