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65 Cards in this Set
- Front
- Back
Severe, unrelenting mid-epigastric pain radiating to the back
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acute pancreatitis
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Severe RLQ pain
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typhilitis
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RUQ tenderness
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VOD
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Burning, aching in the epigstric area radiating to the umbilicus
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gastritis/ulcer
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LUQ pain, hard belly, bloated
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Splenic sequestration
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An acute or chronic inflammation of the pancreas
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Pancreatitis
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Risk factors for pancreatitis
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L-Asparagnase, mercaptopurine, steroids
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Classic signs of pancreatitis
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elevated urinary amylase and elevated serum lipase
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Chemo that has a risk for delayed/prolonged reaction
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Peg-Asparaginase
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Most common presentation of Spinal Cord Compression
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back pain
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Sickledex is not useful because
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it only shows that S cells are present
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Why do sickle cell pt have increased LDH and total Bilirubin
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Chronic destruction
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Treatment for priapism
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LOTS OF FLUIDS. May also give sudafed to vasodilate or call urologist to drain
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Never give demerol because
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it decreases seizure threshold
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Main nursing consideration for acute chest
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use incentive spirometary..usually inpatient and on PCA
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Hydroxuria will not prevent
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Stroke
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What type of disorder is Thalassemia
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Production problem
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Nursing considerations for Thalassemia
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Monitor blood counts (hgb 9-10)
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Effects of iron overload
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-heart and liver damage
-endocrine dysfunction |
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Mixing Study
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normal serum mixed with patients to determine which factors, if any, are missing
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Virchow's Triad
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1. Alterations in normal blood flow
2. Injuries to the vascular endothelium 3. Alterations in the consistancy of blood (hypercoagulability) |
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Evans syndrome
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Combination of hereditary hematological disorders
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When should patients with ITP be transfused
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Only in emergencies such as a life threatening bleed or surgery
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T/F
Steriods increase Platelets |
True
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T/F
Whin-Rho is contraindicated in Rh positive, non-splenectomized patients with ITP. |
False, it is indicated.
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Do not use Whin-Rho if recent
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EBV
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Why is gallstones a risk in patients with hereditary spherocytosis
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They are made of bilirubin from the RBC breakdown
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Presentation of Dyskeratosis Congenita (DKC)
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hyperpigmentation of skin, nail distrophy and oral leukoplakia
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What type of treatment provides the best prognosis in regards to brain tumors
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surgery
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Brain tumor treatment
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-surgery
-radiation -chemo |
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Radiation is not given to childer less than
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3
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Chemo is limited in treating brain tumors because
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cant cross the blood-brain barrier
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Treatment for Astrocytoma
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-GTR: surgery only
-partial resection: surgery, radiation and chemo (Vincristine and carboplatin) |
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Incidence of Astrocytoma
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most common brain tumor
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Grading used for Astrocytoma
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WHO I-IV
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INI-1
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Genetic marker for ATRT
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ATRT prognosis
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very aggressive, only <10% cure
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Diffuse Intrinsic Pontine Glioma is located on
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the brainstem
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Which brain tumor diagnosis has trouble with sedation
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Pontine Glioma
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Symptoms of Ependymoma
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-headache
-nausea/vomiting -increased ICP -memory loss -loss of appetite |
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Prognosis for DIPG (Diffuse Intrinsic Pontine Glioma)
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-no treatment (months to live)
-Pontine gliomas (expires 12-14 months) |
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Medulloblastoma/PNET is located
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Posterior Fossa
-medullo is cerebellar area (lower brain) -PNET is cerebellar (upper brain) |
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Genetics of Medullo/PNET
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Gorlin and Turcot Syndrome
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Sympotoms of medulloblastoma/PNET
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-N/V
-headache -AM vomiting -nystagmus -gait |
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Treatment for Medulloblastoma/PNET
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surgery
radiation |
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Genetic disorder, broad face, rib malformations, predisposition to basal cell carcinoma
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Gorlin Syndrome
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Genetic disorder linked to FAP, cafe-au-lait spots, lipomas (fatty tumors), basal cell carcinoma
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Turcot Syndrome
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Treatment for Medullo/PNET`
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-resection
-RT -chemo |
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Signs of increased ICP
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-am headache
-lethergy -N/V -hydrocephalus -ataxia -blurred vision -neck stiffness -posturing -pupillary changes -Cushing's Triad |
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Cushing's Triad
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-hypertension
-bradycardia -abnormal breathing pattern |
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Acute tumor lysis syndrome
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-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) |
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Acute tumor lysis syndrome Management
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Hydration, alkalinization, allopurinol to reduce uric acid formation and promote excretion of by-products of purine metabolism
Exchange transfusions |
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Hyperleukocytosis
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- WBC count > 100 can lead to capillary obstruction, microinfarction, and organ dysfunction
- Respiratory distress, Cyanosis, Neuro changes: altered LOC, agitation, confusion, ataxia, delirium |
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Hyperleukocytosis Management
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Rapid cytoreduction by chemo with hydration, urinary alkalinization, leukophoresis or exchange transfusions may be needed
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Obstruction
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- 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 |
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Obstruction Management
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Airway protection and Rapid cytoreduction
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Overwhelming Infections
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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. |
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Space occupying lesion located in the CHEST may lead to
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Airway compromise and respiratory failure
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Space occupying lesion in BRAIN my lead to
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Herniation
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Space occupying lesion in SPINAL cord may lead to
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Numbness
Tingling Incontinence or Retention |
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Thrombocytopenia
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Platelets count of 20
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Leukocytosis
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leukocyte count of 100
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Nursing interventions for Daunorubicin/Doxorubicin
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- Cumulative maxium dose (450-550mg/m2)
- doses over 300mg causes irreversable cardiotoxicity - Zenacard (dexrazone) is a cardioprotectant |
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Nursing interventions for Carmustine (BCNU)
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- delayed nadar of 4-6 weeks.
- crossed blood/brain barrier. |
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Nursing interventions for Vincristine
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- constipation
- neuropathy - cumulative neurotoxicities |