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154 Cards in this Set

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