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Flashcards in Test 2 Deck (233)
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1

Written procedures posted at every machine
Required by some state regulatory agencies
Know where emergency offs and circuits are

Emergency procedures

2

Where machine is controlled
Monitor and control linac
Audio and visual

Control console

3

4 states of operational status

Stand-by
Preparatory
Ready
Beam on

4

Machine in "napping" state
Has time delay before it turns on
Keeps electronics warm

Stand-by

5

Shows programmable operational status; record and verify

Preparatory

6

Confirmed program information

Ready

7

Turn key and hear "chirping" sound

Beam on

8

Displayed before or during treatment
Designed to protect patient, employees, and equipment

Interlocks

9

____ Gy (_____ cGy) can be given in 0.3 seconds at 4000 Gy/min if machine set for wrong beam energy

2 Gy (200 cGy)

10

8 examples of interlocks

Beam energy
Beam symmetry, flatness
Dose rate, typical dose
Mechanical hazards
Carousel rotation for different treatment
Bending magnet not steering correctly (BMAG)
Foil fault
Dose/MU 1.2

11

11 new technologies

Conformal therapy
Multileaf collimation (MLC)
Dynamic wedge collimator
Electronic portal imaging (EPID)
On board imagers (OBIs)
Stereotactic radiation therapy
IMRT
Tomotherapy
Image guided radiation therapy (IGRT)
Electronic arcs
Flattening-field free (FFF)

12

Took place of cerrobend blocks; 52-160 leaves made of tungsten
Usually rounded on edges so they don't break if they hit leading to penumbra at end/tip of leaf

Multileaf collimation (MLC)

13

Older; gets more conformal to tumor volume because peripheral dose decreases, tightens everything up to tumor volume
More angles = les dose per field; more beams
Field shape and beam angle change while gantry moves around patient
Allowed by IGRT
"Forward planning" process

Conformal therapy/3D-CRT

14

Flat panel MV receptor across from gantry that gives image; demonstrate poor image quality/contrast

Electronic portal imaging (EPID)

15

kV images on lateral sides of machine, correlates with interaction
Can recreate cone beam CT every 1 degree
Flat panel detector
Offers better detailed image

On board imagers (OBIs)

16

High dose per fraction for hard to reach areas (brain); long prep time, precise
External 3D frame halo: bolts drilled into head and fastened to apparatus that prevents head movement
Planning can take 3-8 hours
Fiducials track movement
Brain tumors, anterior or venous malformations (AVM), etc.

Stereotactic radiation therapy

17

Beam arrangements are tested by trial and error until satisfactory dose distribution is produced

"Forward planning" process

18

IMRT develops treatment plans using this treatment planning; radiation oncologist selects dose parameters for normal tissues and the target volume and computer "back calculates" the desired dose distribution and beam arrangements

"Inverse treatment planning"

19

How much dose is being received within lines

Isodose lines

20

Beams in different planes

Non-coplanar

21

Smaller MLC's used for SBRT/SRS to conform the dose to very small treatment volumes receiving larger or single fraction doses

Micro-/mini-MLCs

22

Curved to match beam divergence; took place of cerrobend blocks

Dynamic wedge collimator

23

3 major components of the linac

Drivestand
Gantry
Couch

24

Collimation: bimodal (open or shut), static
Similar to CT but 6 MV
Very conformal but limited

Tomotherapy

25

Similar to tomo arcing around
More arcs = more time, patient has to stay still the whole time

Electronic/rapid arcs

26

2 types of IGRT

Exac trac
CT overlay

27

Uses infrared tracking to see reference position

Exac trac

28

Makes sure patient is perfectly aligned and if there are any shifts to be made

CT overlay

29

Changing planning right there

Adapted planning

30

Real-time MRI with Co-60

Viewray

31

Computers used to assist therapist in the verification of treatment parameters allow incorrect setup parameters to be corrected before machine is turned on
Computer-assisted setup and recording of patient data reduces erros
Patient information comes from treatment planning computer to machine

Record and verify

32

2 classes of hazards defined by the FDA

Class I
Class II

33

Accident causes death or injury

Class I

34

Accident if risk of serious injury low (operator error, linac error, etc.)

Class II

35

Dmax depth for superficial and orthovoltage

0.0 cm

36

Dmax depth for Cesium 137 and Radium 226

0.1 cm

37

Dmax depth for Cobalt 60

0.5 cm

38

Dmax depth for 4 MV

1.0 cm

39

Dmax depth for 6 MV

1.5 cm

40

Dmax depth for 10 MV

2.5 cm

41

Dmax depth for 15 MV

3.0 cm

42

Dmax depth for 18 MV

3-3.5 cm

43

Dmax depth for 20 MV

3.5 cm

44

Dmax depth for 25 MV

5.0 cm

45

Traditional and SI unit of Cobalt 60

Traditional: Ci
SI: Bq

46

Most sources have an activity of ____-____ Ci

750-9000 Ci

47

To compensate for the reduction in beam output of Co-60 each month (1%), a correction factor of about ___% per month must be applied to the output

1%

48

Electronic equilibrium

Dmax

49

Shielding for Co-60

Cerrobend melts at a much lower point than lead and is therefore easier and safer to use (cadmium)

50

5 methods to expose the Co-60 source

Air pressure (piston)
Rotating wheel
Mercury reservoir
Chain driven
Moving jaws

51

Number of HVLs formula

(1/2)^n = percent transmitted

52

Ratio of cerrobend to lead

12:1

53

2 advisory agencies that don't set regulations for radiation safety procedures

International Commission on Radiological Protection (ICRP)
National Council on Radiation Protection and Measurements (NCRP)

54

Agency that sets regulations for radiation safety procedures

Nuclear Regulatory Commission (NRC)

55

States that enter into agreement with NRC to assume responsibility of enforcing regulations for ionizing radiation

Agreement states

56

3 times full calibration must be done

Sources replaced
5% deviation during QA or spot check
Any major repairs that require removal or restoration of major components

57

5 things full calibration includes

Radiation field-light coincidence
Timer accuracy
Distance measuring devices (ODIs, etc.)
Uniformity of radiation field and dependence based on useful beam
Exposure and dose rate for +/-3% accuracy for multiple field sizes

58

Average leakage and leakage for 1 reading at 1 m

Average = 2 or less mR/hr at 1 m
1 reading at 1 m = 10 or less mR/hr

59

Max permissible leakage in "on" position

0.1% or less of useful beam 1 m from source

60

Filter paper wiped on collimator edges twice a year with long forceps should read less than 0.005 microcurie

Wipe test

61

18-24 in bar to push source back into machine; first 7 in red = pretty safe, 2nd 7 in yellow = source back in housing

T-bar

62

Why dose Co-60 have very high penumbra?

Large source size

63

Increasing energy _______ penumbra; by over 10 MV penumbra _______ again because of Compton

Increases

64

Occurs with straight blocks because of divergence

Transmission penumbra

65

Transmission + geometric penumbra

Physical penumbra

66

Penumbra formula

P = S(SSD+d-SDD)/SDD

67

Increasing SSD and distance from source ______ penumbra; increasing SDD _______ penumbra

Increases, decreases

68

Who insures radiation therapists?

Hospital

69

Discipline dealing with what's good and bad, moral duty and obligation
Set of moral principles or values
Theory or system of moral values
Principles of conduct governing an individual or group
Foundation of law

Ethics

70

Fidelity to conscience; person's concept of right or wrong as it relates to conscience

Morality

71

Loyalty, faithfulness

Fidelity

72

Sum of rules and regulations by which society is governed in any formal and legally binding manner

Legal concepts

73

Foundation of which is ethics, primarily concerned with the good of a society as a functioning unit; exist so we can all live and coexist in formal and legal binding manner we're governed by
Doesn't consider the professional and patient to be on equal terms; greater legal burden/duties are imposed on the healthcare provider

Laws

74

Application of ethics to the bioethical sciences, medicine, nursing, and healthcare

Bioethics

75

7 principles of bioethics

Autonomy
Beneficence
Confidentiality
Justice
Nonmaleficence
Role fidelity
Veracity

76

Patients are independent actors whose freedom to control themselves is to be respected without interference from others

Autonomy

77

Healthcare professionals act in the best interest of patients, even when it might be inconvenient or sacrifices must be made

Beneficence

78

Principle that relates to the knowledge that information received by a patient to a healthcare provider or learned in the course of a healthcare provider performing their duty, is private and should be held in confidence

Confidentiality

79

Fairness and equity maintained among individuals

Justice

80

Directs professionals to avoid harmful acts to patients

Nonmaleficence

81

Principle that reminds professionals that they must be faithful to their role in healthcare environment

Role fidelity

82

Truthfulness specific within healthcare aspect

Veracity

83

3 groups of ethical theories

Teleology/consequentialism
Deontology/nonconsequentialism
Virtue ethics

84

2 forms of teleology/consequentialism

Egoism
Utilitarianism

85

Evaluate good versus bad way person can provide greatest good for most people; ends justify the means

Teleology/consequentialism

86

Best long-term interests of an individual are promoted; in evaluating an act/action for its moral value, it must produce a greater ratio of good over bad for the individual

Egoism

87

Ethical behaviors should be geared toward performing acts that produce the greatest ratio of good to bad

Utilitarianism

88

Uses formal rules for right and wrong for solving problems; duty and right actions to be taken

Deontology/nonconsequentialism

89

Practical wisdom for emotional and intellectual problem solving; practical reasoning and consideration of consequences

Virtue ethics

90

Ways of viewing relationship with patient; use all of these to build a relationship with patient

Models for ethical decision making

91

5 models for ethical decision making

Engineering/analytical
Priestly
Collegial
Contractual
Covenant

92

Dehumanizing approach identifies caregivers as scientist dealing only in facts and doesn't consider the human aspect of the patient/disease

Engineering/analytical model

93

Provides caregiver with godlike attitude forcing patient to do whatever caregiver says regardless of pain

Priestly model

94

Presents a more cooperative method of pursuing healthcare for both provider and patient; consideration
Takes the extra time to get acquainted with patient

Collegial model

95

Maintains a business relationship where information and responsibility are shared; informed consent

Contractual model

96

Recognizes areas of healthcare not always covered by a contract; deals with an understanding between patient and healthcare provider that's often based on traditional values and goals
Go above and beyond to make sure patient gets best treatment; caregiver makes more decisions
Ex: give patient dietary needs, maybe even dietician if necessary

Covenant model

97

Be truthful and give factual information to patient; patient must be competent
Written; must be done before touching patient

Informed consent

98

4 things the patient must be informed of to give informed consent

The nature of the procedure, treatment, or disease
The expectations of the recommended treatment and the likelihood of success
Reasonable alternatives available and the probable outcome in the absence of treatment
The particular known risks that are material to the informed decision about whether to accept or reject medical recommendations

99

Document from American Hospital Association (AHA) that explains expectations when in hospital (confidentiality,etc.)

Patient Care Partnership

100

7 stages of grief cycle

Shock
Denial
Anger
Bargaining
Depression
Testing
Acceptance (DABDA)

101

Initial reaction to hearing news of bad event

Shock

102

Pretending what is, isn't

Denial

103

Outward demonstration of pent-up emotion and frustration

Anger

104

Trying to find a way out of the situation

Bargaining

105

Realization of facts

Depression

106

Searching for realistic resolutions

Testing

107

Coping with the situation and finding a way forward

Acceptance

108

Allows the competent adult to provide direction to healthcare providers concerning their choice of treatment under certain conditions should the individual no longer be competent by reason of illness or other infirmity to make those decision
Takes legal obligation from physician/hospital
Executes patient's wishes (ex: resuscitation)

Living will

109

Joint Commission requires every hospital to have a no code policy

Do-not-resuscitate (DNR)

110

5 things that must be done before executing a living will

Individual demonstrates competency at the time
What done if they code
Pain medications (religion)
Relieves hospital and physician of legal responsibility
Signature has to be witnessed by two disinterested individuals who aren't related, mentioned in will, or have no claim on the estate

111

Represents an intermediate station for patients with terminal illness between life and death
Daily care to make sure patient is comfortable in passing
Physical, moral, and emotional support
Improve and make patients life as tolerable as possible for little time they have left
Patients may enter on their own or may be referred by family, physicians, hospital-affiliated continuing care coordinators and social workers, visiting nurses, friends, or clergy
Life expectancy of 6 months or less
Most families prefer homecare

Hospice

112

Law that governs non-criminal activity, relationships between individuals

Civil laws

113

Type of civil law, wrongful act committed against a person
Allows compensation to be paid to an individual damaged or injured by another

Tort

114

2 types of torts

Intentional
Unintentional

115

Willful acts meant to be done

Intentional tort

116

Those acts that aren't intentionally harmful but still result in damage to property or injury to person
Ex: failure of healthcare provider to provide properly for the safety of a patient or failure to properly educate a patient, resulting in harm

Unintentional tort

117

7 intentional torts

Assault
Battery
False imprisonment
Libel
Slander
Invasion of privacy
Negligence

118

Threat of touching in an injurious way

Assault

119

Actual act of harmful, unconsented, or unwarranted contact with an individual

Battery

120

Intentional confinement without authorization by a person who physically constricts another with force, threat of force, or confining clothing or structures

False imprisonment

121

Written defamation of character

Libel

122

Oral defamation of character

Slander

123

Charges may result if confidentiality of information hasn't been maintained or the patient's body has been improperly and unnecessarily exposed or touched

Invasion of privacy

124

Neglect or omission of reasonable care or caution

Negligence

125

Failure to follow appropriate standards of care

Medical negligence/malpractice

126

4 legal doctrines

Doctrine of Personal Liability
Doctrine of Respondeat Superior
Doctrine of Res Ipsa Loquitur/"the thing speaks for itself"
Doctrine of Foreseeability

127

Persons are liable for their own negligent conduct; law doesn't permit wrongdoers to avoid liability for their own actions, even though someone else may also be held liable for the wrongful conduct
Therapists can be held responsible for their own negligent actions

Doctrine of Personal Liability

128

An employer is responsible for negligent acts of employees that occur while they're carrying out the orders or serving the interests of the employer; certified, come from accredited program, etc.

Doctrine of Respondeat Superior

129

Requires the defendant to explain the events and convince the court that no negligence was involved; the Standards of Practice for Radiation Therapists may be used by either the defense of the prosecution to support or refute negligent behavior

Doctrine of Res Ipsa Loquitur/"the thing speaks for itself"

130

Principle of law that holds an individual liable for all natural and proximate consequences of negligent acts to another individual to whom a duty is owed
The negligent acts should or could have been reasonably foreseen under the circumstances
Injury suffered must be related to the foreseeable injury

Doctrine of Foreseeability

131

Believed to be the key element in loss prevention from adverse medical incidents and links every quality improvement program with measurable outcomes
Tolerances, determine effectiveness with consideration to patient's safety

Risk management

132

Any happening that isn't consistant with the routine operation of the hospital or the routine care of a particular patient

Incident

133

7 rationales for and documentation of treatment

Written patient history, radiographic results
Patient progress
Notes from weekly treatment visits
Blood counts, weights
Treatment indicators/responses
Why patient's being treated the way they are
Written and included in patient's chart

134

Kept separate/in department from patient's individual medical records
Patient's name and hospital ID number on each page
Should be legible and in pen
If mistake made, cross it out with one line and initial and date it
QA: ID, consent, diagnostic dictations, etc.

Radiation therapy chart

135

Consolidate, organize, and document an individual's healthcare experience
Demonstrates why patient's being treated

Medical records

136

Computer-hosted medical record provides collection and storage of information and facilitation of the patient encounter by providing the clinician with the most relevant information for the specific task at hand

Electronic medical record (EMR)

137

Focuses on total/overall health of patient, cross the lifetime of individuals; provides complete and accurate information and easier/better access to their information and gives patient empowerment (have access and can share as needed)

Electronic health record (EHR)

138

Assembly of tasks performed to accomplish a goal, can be very simple or complex

Workflow

139

Online management of the entire order tracking and documentation process from order entry to return of results and is a standard workflow component of an electronic chart

Computerized physician online order entry (CPOE)

140

4 input methods

Keyboard and mouse
Speech/voice recognition systems
Peripheral devices
Direct communication

141

4 peripheral devices

Barcodes
Biometric devices: fingerprint/retinal scanners
Cameras and scanners
Electronic completion devices: signature pads

142

Provides overall viewpoint/picture of health in certain country; took charge of publishing mortality classifications (1950s)

World Health Organization (WHO)

143

Set up standards to code and tabulate mortality and morbidity data
Made easy to calculate statistics (ex: cell type, classifying diseases, cause of death, level of pain)

International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD)

144

Step-by-step process for how something should be done
Finite set of instructions used by computers to compute a desired result (ex: diagnosis code and tumor size, node, and metastatic state data can calculate disease stage which saves clinician time)
Can compare medications and patient allergies; can be simple or complex
Treatment-planning computers

Algorithm

145

Stores and transfers images

Picture Archiving and Communication System (PACS)

146

Refers to graphic, textual, and auditory information the program presents to the user and the input methods the user employs to control the program; what is seen, usability of system

User interface

147

2 interfaces

Proprietary
Standards-based/open systems development

148

Developed and owned by private or commercial entities; for sale/not free, widely used in radiation oncology (ex: Varian linac)
Drawback: duplication of effort with solving of common problems in unique ways

Proprietary interfaces

149

Developed by national and international committees accredited by organizations such as the American National Standards Institute (ANSI) or International Standards Organization (ISO)

Standards-based interfaces/open systems development

150

2 examples of standards-based interfaces/open systems development

Health Level 7 (HL7)
Digital Imaging and Communications in Medicine (DICOM)

151

Defines comprehensive framework and standards for the exchange, integration sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery, and evaluation of healthcare services
Enable sharing of patient information useful across entire healthcare facility

Health Level 7 (HL7)

152

20 standards specific to imaging and transferring this information, used for PACS
Produced by National Electrical Manufacturers Association (NEMA) and the ACR
Describes each type or information that may be transferred

Digital Imaging and Communications in Medicine (DICOM) 3

153

Each type or information that may be transferred

Information Object Definitions (IOD)

154

6 IODS

Radiation therapy (RT) image
RT dose
RT structure set
RT plan
RT beams and RT brachytherapy
RT treatment summary

155

Conventional and virtual simulation images, DRRs, and portal images

Radiation therapy (RT) image

156

Dose distributions, isodose lines, dose-volume histograms (DVH)

RT dose

157

Plot of target or normal structure volume as function of dose

Dose-volume histograms (DVH)

158

Volumetric contours drawn from CT images

RT structure set

159

Text information that describes treatment plans, including prescriptions and fractionation, beam definitions, and so forth

RT plan

160

Treatment session reports for external beam or brachytherapy may be used as part of a record and verify (V&R) system

RT beams and RT brachytherapy

161

Cumulative summary information may be used after treatment to send information to a hospital EMR

RT treatment summary

162

A system of independent, interconnected computers or terminals communicating with one another over a shared medium, consisting of hardware and communication protocols; requires special hardware, including cards within the computers and particular cables

Network

163

Most common protocol

Ethernet

164

Formed to improve computerized systems in radiation oncology; provides a platform for the radiation oncology team, administrators, and industry representatives to address these issues and develop solutions that ensure the clinic delivers the most optimal care

Integrating the Healthcare Enterprise for Radiation Oncology (IHE-RO)

165

3 networks

Local area network (LAN)
Wireless local area network (WLAN)
Wide area network (WAN)

166

A network geographically confined to an area in which a common communication service may be used (ex: home, school, office, etc.); can implement EMR software

Local area network (LAN)

167

Allows users to connect to a local area network via a wireless connection

Wireless local area network (WLAN)

168

Uses telephone, T1 lines, T3 lines (T1 moves more data than T3, both expensive) or internet for larger geographic areas or multiple LANs

Wide area network (WAN)

169

Allows one to have applications and data stored off-site and maintained by this
Users access this information through secure and private internet connections; makes charts available from any internet connection
Implements EMR software
Provides server that can house a lot of information as opposed to a system and can be accessed anywhere with secure systems

Application service providers (ASPs)

170

Most common method of restricting access

Passwords

171

Require security precautions to not only restrict access but also keep records of who is accessing information

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

172

Organization, analysis, management, and use of information in healthcare

Medical informatics

173

Combines all the EMR information with scientific evidence, helps define clinical care for the patient

Evidence-based care

174

Reduce disease and promote health through communities

National public health agencies

175

3 national public health agencies

National Institutes of Health (NIH)
Food and Drug Administration (FDA)
Centers for Disease Control and Prevention (CDC)

176

Provide research to combat disease

National Institutes of Health (NIH)

177

Ensure safety of food, cosmetics, pharmaceuticals, biological products, and medical devices (linacs)

Food and Drug Administration (FDA)

178

Work with states and other partners to help observe disease, surveillance
Bioterrorism
Implement disease-prevention strategies and maintain national health statistics
Main purpose: provide and increase security if health within nation

Centers for Disease Control and Prevention (CDC)

179

Information system designed for the collection, management, and analysis of data on people with the diagnosis of cancer

Cancer registry

180

Data-gathering process in cancer registry

Abstracting

181

3 classifications of cancer registries

Health care institution registry/hospital-based
Central registries
Special purpose registries

182

Focuses on all patients who are diagnosed or treated for cancer within a specific center
Don't distinguish where patient is from and institution must follow everyone who passes through its doors
Tracking required by law to be passed up to a state or central agency

Health care institution registry/hospital-based

183

Compilations of all the healthcare institution registries that are then broken down by specific geographic areas
Show larger scale trends than individual cancer centerq

Central registries

184

Maintain data regarding a particular type of cancer, can be established if initial data at institutional or central level point toward potential trends

Special purpose registries

185

Boost

Cone down (CD)

186

Anatomical site to be treated/diagnosis, total dose (TD), daily or by-daily (BID) fractions, number of fractions/c, schedule of treatment, treatment technique/modality (photons, electrons, etc.), beam energy, port size/field size, angles/entry of angles or number of arcs, beam modifiers (block, wedges, bolus, etc.), patient position, signature and date by physician

Prescription

187

Time over which TD is delivered

Protractions

188

Date of treatment, treatment number, elapsed days (ED), daily dose, total dose, portal films, cumulative dose (CD)
Dated and signed by therapist
Can keep critical structures dose; helps keep track of changes (ex: boost, change in tumor size)

Daily treatment record

189

Most common charting error

Addition and transcribing

190

Portal films done on a minimum ______ basis

Weekly

191

2 errors

Systemic
Random inherent variations in daily setup such as positioning, movement, etc.

192

Variation in the translation of the treatment setup from simulation to treatment unit

Systemic error

193

Take first exposure with 1-2 MU and open up collimation to take second exposure with less MUs or use OBI (kV) to see blocked field and organs behind it

Double-exposure film

194

Calculations must be checked _____

Twice

195

2 verbal cues

Cognitive
Affective

196

Composed of the actual facts and words contained in the message; ex: ointment

Cognitive

197

Express feelings, emotions, attitudes, and behavior rather than words; can be more difficult

Affective

198

Over ____ communication is transmitted nonverbally

2/3

199

Identifying with the feelings, thoughts, or experiences of another person

Empathy

200

Verbal counterpart to occasional head nodding/nonverbal cues such as "yes, uh huh, and I see" and indicate the healthcare provider is listening to and understanding the patient

Minimal verbal responses

201

Healthcare provider is listening to an understanding the patient's concerns and perspectives; workers can reflect the specific content or implied feelings of their nonverbal communication they feel has been omitted or emphasized

Reflecting

202

Verbal statement that's interchangeable with a patient's statement

Paraphrasing

203

Open-ended statement used to obtain more information

Probing

204

Used to obtain more information about vague, ambiguous, or conflicting statements

Clarifying

205

Therapists are genuinely confused about their perceptions of the patient's verbal or nonverbal behavior or have a hunch something should be examined; verbal and nonverbal cues not adding up

Checking out

206

Therapist adds something to the patient's statement or tries to help the patient understand underlying feelings

Interpreting

207

Therapist shares objective and factual information; ex: low blood cell count

Informing

208

Therapists making the patient aware that their observations aren't consistent with the patient's words; response must be done with respect to the patient and extreme tact so that a defensive response isn't elicited

Confronting

209

Therapist condenses and puts in order the information communicated

Summarizing

210

Loss of appetite resulting in weight loss

Anorexia

211

Complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass; affects 1/2-2/3 of cancer patients

Cachexia

212

Cachexia causes issues with GI tract (irritated, sore, etc.) and is treated with IV fluids with glucose, amino acids, nutrients, vitamins, etc.

Hyperalimentation

213

3 types of malnutrition

Marasmus
Kwashiorkor
Combination

214

Calorie malnutrition causes fat and muscle to deplete in body resulting in weight loss of 7-10%

Marasmus

215

Protein malnutrition but have enough carbohydrates and fats characterized by retarded growth, muscles waste away, can see depigmentation in skin and hair, edema (ascites), and depressed immune system

Kwashiorkor

216

Most life threatening malnutrition characterized by weight loss of 10% or more
Depletes all protein in body and immune system deteriorates
Common in children

Combination

217

6 dimensions to consider in assessing and managing the experience of cancer pain

Physiologic
Sensory
Affective
Cognitive
Behavioral
Sociocultural

218

Organic cause of pain

Physiologic

219

Pain intensity, location and quality

Sensory

220

Depression and anxiety

Affective

221

Pain influences thought process and patient views themself in a different, usually negative way

Cognitive

222

Usually bad pain-related behaviors such as self medication-intake and dependence and lowered activity levels; irritable

Behavioral

223

Cultural background, being raised in certain culture/religion affects how patient deals with pain (ex: no medication)
Females and geriatrics vocalize pain more than others

Sociocultural

224

Assesses functional performance

Karnofsky scale

225

Decrease in the peripheral red blood cells

Anemia

226

Decrease in the white blood cells

Leukopenia

227

Reduction in the number of circulating platelets

Thrombocytopenia

228

Dynamic process directed toward the goal of enabling persons to function at their maximum level within their physical, mental, emotional, social and economic potential; need to consider the side effects of radiation

Rehabilitation

229

The perceived loss of self-esteem resulting in a cluster of affective behavioral (change in appetite, sleep disturbances, lack of energy, withdrawal, and dependency) and cognitive responses (decreased ability to concentrate, indecisiveness, and suicidal ideas)

Depression

230

Depression criteria: ___ or more symptoms present for ___ or more weeks

5 or more symptoms present for 2 or more weeks

231

9 criteria for depression

Depressed mood
Diminished interest or pleasure
Significant weight loss when not dieting or weight gain
Insomnia or hypersomnia
Psychometer agitation or retardation
Loss of energy or fatigue
Feelings of worthlessness
Diminished ability to think
Suicidal

232

Holistic approach to patient care; encompasses a sense of fulfillment and connection with a power greater than oneself and a person's need to find satisfactory answers to questions that revolve around the meaning of life, illness, and death

Spiritual assesment

233

Key concept and an essential ingredient in the religious and spiritual aspects of care and a major component in the healing process
Giving realistic support is a powerful gift oncology caregivers can offer to patient
Can help physically, emotionally, and physiologically

Hope