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65 Cards in this Set

  • Front
  • Back
Severe, unrelenting mid-epigastric pain radiating to the back
acute pancreatitis
Severe RLQ pain
RUQ tenderness
Burning, aching in the epigstric area radiating to the umbilicus
LUQ pain, hard belly, bloated
Splenic sequestration
An acute or chronic inflammation of the pancreas
Risk factors for pancreatitis
L-Asparagnase, mercaptopurine, steroids
Classic signs of pancreatitis
elevated urinary amylase and elevated serum lipase
Chemo that has a risk for delayed/prolonged reaction
Most common presentation of Spinal Cord Compression
back pain
Sickledex is not useful because
it only shows that S cells are present
Why do sickle cell pt have increased LDH and total Bilirubin
Chronic destruction
Treatment for priapism
LOTS OF FLUIDS. May also give sudafed to vasodilate or call urologist to drain
Never give demerol because
it decreases seizure threshold
Main nursing consideration for acute chest
use incentive spirometary..usually inpatient and on PCA
Hydroxuria will not prevent
What type of disorder is Thalassemia
Production problem
Nursing considerations for Thalassemia
Monitor blood counts (hgb 9-10)
Effects of iron overload
-heart and liver damage
-endocrine dysfunction
Mixing Study
normal serum mixed with patients to determine which factors, if any, are missing
Virchow's Triad
1. Alterations in normal blood flow

2. Injuries to the vascular endothelium

3. Alterations in the consistancy of blood (hypercoagulability)
Evans syndrome
Combination of hereditary hematological disorders
When should patients with ITP be transfused
Only in emergencies such as a life threatening bleed or surgery
Steriods increase Platelets
Whin-Rho is contraindicated in Rh positive, non-splenectomized patients with ITP.
False, it is indicated.
Do not use Whin-Rho if recent
Why is gallstones a risk in patients with hereditary spherocytosis
They are made of bilirubin from the RBC breakdown
Presentation of Dyskeratosis Congenita (DKC)
hyperpigmentation of skin, nail distrophy and oral leukoplakia
What type of treatment provides the best prognosis in regards to brain tumors
Brain tumor treatment
Radiation is not given to childer less than
Chemo is limited in treating brain tumors because
cant cross the blood-brain barrier
Treatment for Astrocytoma
-GTR: surgery only
-partial resection: surgery, radiation and chemo (Vincristine and carboplatin)
Incidence of Astrocytoma
most common brain tumor
Grading used for Astrocytoma
Genetic marker for ATRT
ATRT prognosis
very aggressive, only <10% cure
Diffuse Intrinsic Pontine Glioma is located on
the brainstem
Which brain tumor diagnosis has trouble with sedation
Pontine Glioma
Symptoms of Ependymoma
-increased ICP
-memory loss
-loss of appetite
Prognosis for DIPG (Diffuse Intrinsic Pontine Glioma)
-no treatment (months to live)
-Pontine gliomas (expires 12-14 months)
Medulloblastoma/PNET is located
Posterior Fossa
-medullo is cerebellar area (lower brain)
-PNET is cerebellar (upper brain)
Genetics of Medullo/PNET
Gorlin and Turcot Syndrome
Sympotoms of medulloblastoma/PNET
-AM vomiting
Treatment for Medulloblastoma/PNET
Genetic disorder, broad face, rib malformations, predisposition to basal cell carcinoma
Gorlin Syndrome
Genetic disorder linked to FAP, cafe-au-lait spots, lipomas (fatty tumors), basal cell carcinoma
Turcot Syndrome
Treatment for Medullo/PNET`
Signs of increased ICP
-am headache
-blurred vision
-neck stiffness
-pupillary changes
-Cushing's Triad
Cushing's Triad
-abnormal breathing pattern
Acute tumor lysis syndrome
-Caused by rapid release of intracellular metabolites during the initial treatment of malignancies.
- Leads to: Hyperuricemia, Hypocalcemia and Hyperkalemia
-Flank pain, lethargy, n/v, oliguria, pruritis, tetany, altered LOC, renal failure (dialysis may be needed)
Acute tumor lysis syndrome Management
Hydration, alkalinization, allopurinol to reduce uric acid formation and promote excretion of by-products of purine metabolism
Exchange transfusions
- WBC count > 100 can lead to capillary obstruction, microinfarction, and organ dysfunction
- Respiratory distress, Cyanosis, Neuro changes: altered LOC, agitation, confusion, ataxia, delirium
Hyperleukocytosis Management
Rapid cytoreduction by chemo with hydration, urinary alkalinization, leukophoresis or exchange transfusions may be needed
- Space occupying lesion located in the CHEST = airway compromise and respiratory failure
- Space occupying lesion in BRAIN = herniation
- Space occupying lesion in SPINAL cord = numbness, tingling, incontinence or retention
Obstruction Management
Airway protection and Rapid cytoreduction
Overwhelming Infections
Gram-negative sepsis can result in numerous complications:
DIC: Life-threatening hemorrhage in combination with thrombocytopenia, platelet count of 20 and leukocytosis, (leukocyte count of 100) can cause intracranial bleeding from increased viscosity of the blood.
Space occupying lesion located in the CHEST may lead to
Airway compromise and respiratory failure
Space occupying lesion in BRAIN my lead to
Space occupying lesion in SPINAL cord may lead to
Incontinence or Retention
Platelets count of 20
leukocyte count of 100
Nursing interventions for Daunorubicin/Doxorubicin
- Cumulative maxium dose (450-550mg/m2)
- doses over 300mg causes irreversable cardiotoxicity
- Zenacard (dexrazone) is a cardioprotectant
Nursing interventions for Carmustine (BCNU)
- delayed nadar of 4-6 weeks.
- crossed blood/brain barrier.
Nursing interventions for Vincristine
- constipation
- neuropathy
- cumulative neurotoxicities