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154 Cards in this Set
- Front
- Back
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What is tumor lysis syndrome?
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chemo or radiation destroys cells and causes problems
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What increases and decreases with tumor lysis syndrome?
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hyperkalemia, hyperuricemia, hyperphosphatemia, hypocalemia
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What is the nursing intervention for tumor lysis syndrome?
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push 3L of fluid a day
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What medication is given prophalactically for tumor lysis, why?
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allopurinol --> revent buildup of uric acid adn gout
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What is superior vena cava syndrome?
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obstruction of SVC by tumors
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What are the S&S of SVC syndrome?
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venous distention of neck, facial edema, edema of upper extremities, dyspnea (most common)
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What should the nurse do with a suspected SVC syndrome?
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call MD stat, give O2, ^HOB, remain with pt to ensure airway
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What are S&S of hypercalcemia?
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apathy, depression, muscle weakness, EKG changes, fatigue anorexia, n/v
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What is the nursing interventions for hypercalcemia?
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push 3 L of fluids a day
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What medications are given for hypercalcemia?
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loop diuretics and biphosphinates
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What lab values would be alarming for a cancer pt?
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leukocytosis, neutropenia, thrombocytopenia, anemia
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What is leukocytosis?
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elevated WBC
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What does leukocytosis indicate?
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presence of infection
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What is neutropenia?
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low WBC/neutrophils
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What is the potential problem with neutropenia?
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can't mount an immune response
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What do you do with a pt that is neutropenic with a fever?
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medical emergency, call MD, that pt is priority
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What is thrombocytopenia?
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low platelet count
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What nursing interventions should be implemented for thrombocytopenia?
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no floss, soft tooth brush, no IM injections
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What is a shift to the left?
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bands outnumber neutrophils, pts has an overwhelming infection
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What kinds of precautions are done fro neutropneic pts?
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revers isolation, no fresh fruits, flowers or veggies, no IV or IM injections
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What king of veggies can neutopenic pts eat?
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canned
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What are colony-stimulating factors?
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substances that stimulate the production of blood cells and promote their ability to function
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What is neupogen?
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colony-stimulating factor for neutrophils
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What is aranesp?
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colony-stimulating factor for RBC
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What is epogen?
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colony-stimulating factor for RBC
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What are the side effects of colony-stimulating factors?
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flu-like symptoms
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What do you treat the side effects of colony-stimulating factors with?
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Tylenol
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What are biological response modifiers?
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substances that are able to trigger the immune system to indirectly affect tumors
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What drugs are biological response modifiers?
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cytokines, interferons, interleukines
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What are the side effects of biological response modifiers?
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inflammatory symptoms and profound flu-like symptoms
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What are the SE of biological response modifiers treated with?
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Tylenol
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What is stomatitis?
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inflammation of mucosal linings associated with chemo and radiation
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What is the focus concerning stomatitis?
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pain control
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When should mouth care be done with stomatitis?
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before and after meals
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What nursing interventions are for stomatitis?
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rinse mouth with salt water, keep hydrated with litter sips of water
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What care needs to be done for radiation burns?
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use water and mild soap, don't wash off marks, no lotions, treat like sun burn
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What should be encouraged after chemo treatment?
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rest
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How is pain managed for cancer pts?
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round the clock pain mgmt and then extra for breakthrough
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What is primary concern for IV chemo sites?
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extravasation doesn't occur
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What is multiple myeloma?
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cancer of the plasma cells
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What are nursing interventions for multiple myeloma?
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same as neutropenic precautions and bleeding precautions
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What are well differentiated cells?
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Cancer cells that look like the parent
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What are poorly differentiated cells?
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cells that lack teh structure and funciton of normal cells
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What is acute lymphocytic leukemia?
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most common leukemia in kids under 20
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What test are done to confirm ALL?
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CBC, bone marrow aspiration, and bone marrow biopsy
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How is the patient laying during a bone marrow aspiration?
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prone
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What factors are necessary to be dx with AIDS?
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CD4 less that 200, presence of opportunistic infection
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What is PCP?
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opportunistic infection pneumocystic carini/jirovecii pneumonia
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What med treats PCP and how is it given?
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pentam --> IV or nebulizer
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What do you need to watch for with pentam?
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BG and BP QH
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What is the first step to pt education?
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find out how much they know and go from there
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What is Kaposi's sarcoma?
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malignancy associated with AIDS, manifests as purpilish lesions
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What is Type 1 diabetes?
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lack of insulin
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Type 2 diabetes?
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insufficient insulin and increased insulin resistance
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What is normal HgbA1C?
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4-6
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What is the most common rapid acting insulin?
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Lispro
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What is the most common short acting insulin?
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Regular
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What is the most common intermediate acting insulin?
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NPH
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What is the most common long acting insulin?
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Lantus
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What are the S&S of hypoglycemia?
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cold, clammy, dyphoresis
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What is microalbumuria?
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protein in the urine and earliest predictor of kidney involvement in diabetes
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What is peripheral neuropathy treated with?
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anticonvulsants --> neurontin
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What do diabetics need to know considering neuropathy?
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daily inspection of feet, toenail care by podiatrist, wear well fitting shoes, test bath water
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What kind of eye exams do diabetics need?
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dilated annual exams with an ophthalmologist
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Other than glucose what do we need to monitor during DKA?
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K+
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What are the levels of T3, T4, and TSH in hypothyroid?
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T3/T4 down
TSH up |
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What do you treat hypothyroid with?
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Synthroid
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What is myxedema coma?
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extension of hypothyroid S&S that results in a coma
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What is the treatment for myxedema coma?
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IV synthroid
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What is the greatest concern with myxedema coma?
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hypoxia
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What is Hashimoto's thyroidistis?
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autoimmune disease which attacks the thyroid
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What are the ranges with Grave's disease?
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T3/T4 up
TSH down |
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What are the ranges with non-Grave's disease?
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T3/T4/TSH up
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What is of main concern with hyperthyroidism?
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cardiac function
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What is myxedema?
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hypothyroidism diagnosed as adult
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What is cretinism?
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hypothyroidism dx upon birth
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what causes Cushing's disease?
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excess produciton of cartisol
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What causes Cushing's syndrome?
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corticosteroids
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What are the S&S of Cushing's disease?
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moon face, hump back
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What are the side effects of corticosteroids?
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increase blood glucose, thinning of the skin, osteoporosis, emotional liability, weight gain
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What is Addison's disease?
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deficiency of cortisol
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what is S&S of SIADH
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hyponatremia, high specific gravity of urine, little amounts of urine
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What do you treat SIADH with?
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fluid restriction of 800-1,000 ml/day and demeclomycin
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What are the S&S of diabetes insipidus?
What is it treated with? |
high urine output, low specific gravity
DDAVP or desmopresin |
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What is acromegly?
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excess secretion of GH after puberty
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What is giantism
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excess secretion of GH before puberty
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what the difference in S&S between acromegly and giantism?
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Acromegly: hads, fee, and face big
Giantism: everything's big |
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What does parathyroid control?
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Ca & P
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What results from hypoparathyroidism?
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hypocalcemia
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What are the S&S of hypocalcemia?
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circulmoralparathesia, muscle cramps, muscle spasms, seizures, tetany
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what does hyperparathyroidism result in?
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hypercalcemia
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What results form hypercalcemia?
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caliculi/calcium stones
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what is the goal of seizure medications?
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protect pt form injury not prevent seizures
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What med is used for status epilepticus?
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IV antivana dn valium
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What is the goal of Parkinson's treatment?
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let them be as independent as possible, maintain, dignity, thickened fluids
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When dealing with Alzheimer's what is the best tactic?
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diversion
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What does fatigue do with Alzheimer's
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increases confusion
(should promote sleep at all stages) |
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What is the priority with an Alzheimer's pt that wanders?
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pt safety
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When in Alzheimer's is reorientation ineffective?
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Stage 2-3
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What needs to be done to detect what type of CVA?
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CT scan
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What is the number one risk factor for CVA?
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hypertension
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what is guillian-barre syndrome?
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autoimmune disorder affecting pns; ascending paralysis
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What triggers GB?
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viral infection
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What is of greatest concern with GB?
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respiratory
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when is RLS the worst?
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When the pt is trying to rest
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What pt ed should be given for RLS pts?
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decrease caffeine, alcohol, tobacco; take supplements; maintain regular sleep patterns; moderate exercise; massaging legs; take hot bath; use temp therapy
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What are the 3 parts of the Glasgow coma scale?
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eye opening, verbal response, motor response
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What is MG?
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pts are stronger int eh morning and weaker with activity
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What test is for MG?
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tensilon
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What drug is given for MG?
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mestinon
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what drugs treat gout?
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Allopurinol and Colchicine
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What type of exercise are best for osteoporosis?
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weight baring
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What si a good indication of oseoporosis?
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loss of height
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what test measures bone density?
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DEXA scan
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What is osteopmalacia?
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softening of bones due to defective boen mineralization
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what is osteomalacia in children?
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Rickets
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What should a person low in Vit D do to bring it back up?
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have sunlight exposure, increase Vit D in diet
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What is skeletal traction?
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pins are placed directly thought the bone to obtain proper alignment of the bones and keep them in alignment
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What is the risk with skeletal traction?
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osteomyelitis
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What is the medication for RA?
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methotrexate
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What is typically the cause of death with SLE?
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kidney failure
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Regarding sun exposure what should SLE pts know?
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limit, wear sunscreen
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What should a pt know that is going to have a PET scan?
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no caffeine at least 8 hours prior to the exam
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What medication works well for osteoarthritis?
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NSAIDS
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What types of exercises are best for osteoarthritis?
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non weight baring
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What is the range for Ca?
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8-10
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What is the range for Na?
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135-145
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What is urine specific gravity?
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1.010-1.030
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What is the range for WBC?
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5,000-11,000
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What is the range for RBC?
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4.5-6.0 million
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What is the range for Hct?
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35-45%
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What is the range for Hgb?
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12-16
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What is the range for plt?
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150,000-450,000
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What is a dilantin level?
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10-20
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What is a digoxin level?
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0.8-2.0
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How many mls are in a teaspoon?
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5
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How many mls are in a tablespoon?
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15
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How many mls are in an oz?
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30
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What does Stoke's sign look like?
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pulling away from the neck like a man with a tie
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What does Stoke's sign indicate?
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SVC
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How many neutrophils should there be?
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55-70
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What should be known about the bifosfinates?
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take on empty stomach, take with a full glass of water, sit up for 30-60 min after taking
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What is MS?
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autoimmune disease that causes gradual destruction of mylen sheath, causes muscle weakness
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What drug is used to treat MS?
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methyleprednisone and corticosteroids
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What is ALS?
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atrophy of hands and legs and eventually results in paralysis and death, minds remain intact
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What is Trousseau's sign?
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put BP cuff on pt, blow it up, tap wrist and your thumb abducts, for low Ca
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What is Chvostek's sign?
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top on fifth cranial nerve and they twitch on one side of face, for low Ca
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What is the onset and peak of rapid actin insulin?
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Onset: 5-15 min
Peak: 1-2 hours |
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What is the onset and peak of short acting insulin?
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Onset: 30-60 min
Peak: 2-4 hours |
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What is the onset and peak of intermediate acting insulin?
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Onset: 1-2 hours
Peak: 4-8 hours |
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How does metformin work?
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decreases sugar production in the liver and helps the muscles use insulin to break down sugar
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What medication treats Addison's disease?
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Florinef (Fludrocortisone)
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What medication treats Cushing's disease?
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Cytadren (Aminoglutethimide)
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What are the SE of cryptosporidiosis and what is it?
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disease caused by an intestinal parasite. Watery diarrhea and often abdominal cramping
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