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75 Cards in this Set

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David, age 67 years, is admitted for diagnostic studies to rule out cancer. He is white, has been employed as a landscaper for 40 years, and has a 36-year history of smoking one pack of cigarettes a day. David has three risk factors associated with the development of cancer. choose the least significant risk factor among the following
a. age b. occupation
c. sex d. race
d. race
When a patient takes vincristine, a plant alkaloid, the nurse should assess for symptoms of toxicity affecting the
nervous system
A 43 year old woman is undergoing chemotherapy treatment for uterine cancer. She asks the nurse how chemotherapeutic drugs work. The most accurate explanation would include?
They affect all rapidly dividing cells.
Cancer cells are characterized by rapid division. Some, but not all, chemotherapeutic drugs affect molecular structure. Chemotherapy slows, not stimulates, cell dividing. all cells are sensitive to drug toxins, but not all chemotherapeutic drugs are toxins; there are several different mechanisms of action
alopecia
hair loss
John's WBC and platelet counts are critically low. He is febrile and complaining of a headache and constipation. Which is the most appropriate nursing intervention for this client?
Temperature and neurological status need to be closely monitored in leukemic clients, who are at particular risk for infection and intracranial bleeding.
to reduce nitrate intake because of possible carcinogenic action, the nurse suggests that a patient decrease his or her intake of:
a. eggs and milk b. fish and poultry c. ham and bacon d. green, leafy vegetables
c. ham and bacon
Initial nursing action for extravasation of a chemotherapeutic agent includes all of the following ;
immediately discontinuing the infusion; injecting an antidote, if required; placing ice over the site of infiltration(yu don't applying warm comopresses to the phlebitic area)
An adult experiences severe vomiting from cancer chemotherapy drugs. Which acid-base imbalace should the nurse anticipate?
Metabolic alkalosis
sever vomiting results in a loss of hydrochloric acid and acids from extracellular flulids, leading to metabolic alkalosos.
carcinogenisis
the process of transforming normal cells into malignant cells
As a result of the intensive chemotherapy, John has extensive stomatitis. In order to alleviate the stomatitis pain, you would?
Topical and systemic analgesics are indicated. - Administer acetaminophen elixir and oral topical anesthetic every 4 hr.
an endoscopic procedure can be used to remove an entire piece of suspicious tissue growth. the diagnostic biopsy method used for this procedure is known as
excisional biopsy
realizing that chemotherapy can result in renal damage, the nurse should
encourage fluid intake to dilute the urine
A woman loses most of her hair as a result of cancer chemotherapy. The nurse understans that shich of the following is true about chemotherapy-induced alopecia?
The hair loss is temporary.
While hair color and texture may change following loss due to chemotherapy.Hair loss i;s a serious threat to self-esteem in the client receiving chemotherapeutic drus. Clients who will be receiving medications known to cause hair loss should be encouraged to purchase a wig shile they still have hair to allow for matching.
cytokines
substances produced by immune system cells to enhance the immune system
Mr. Smith asks you, "Is this this bronchoscopy necessary? I must have lung cancer after all of these years of smoking. Why doesn't the doctor just start treatment?" your best response would be:
"Your doctor can't tell for certain that you even have lung cancer unless a tissue speciemn is examined for the presence of cancer cells."
a patient is admitted for an excisional biopsy of a breast lesion. The nurse should do all of the following
clarify information provided by the physician; provide aseptic care to the incision postoperatively; provide time for the patient to discuss her concerns.
allopurinol may be prescribed for a patient who is receiving chemotherapy to
lower serum and urine uric acid levels
A 24 year old is diagnosed with Hodgkin's disease Stage 1A. He is being treated with radiation therapy. To minimize skin damage from radiation therapy, the nursing care plan should include which of the following?
Avoid applying creams and powders to the area.
They may contain heavy metals, will further irritate skin sensitized by radiation therapy and reduce the effectiveness of therapy by blocking radiation.
metastasis
the spread of cancer cells from the primary tumor to distant sites
Ms. Smith is diagnosed with small-cell lung carcinoma. Her physician has chosern an imtensive combination chemotherapy regimen with which to treat her. In preparation for chemotherapy, you would tell her:
Chemotherapy is administered intermittently over a specified period of time, in repeated sequences referred to as cycles. Chemotherapy can be given by a variety of routes. There are multiple potential side effects
surgery done to remove lesions that are likely to develop into cancer is known as
prophylactic
the use of hyperthermia as a treatment modality for cancer may cause
fatigue, NV, hypotension, skin burn, and tissue damage, thrombophlebitis, diarrhea, and peripheral neuropathies
An adult develops a second-degree or secondlevel skin reaction from radiation therapy. When evaluation his symptoms. the nurse can expectto find all of the following ecxcept
Reddening of the skin will not be seen in a second-level or second-degree skin reaction. A second-degree skin reation would be evidenced by scaly skin, an itchy feeling, and dry desquamation.
nadir
the lowest point of white blood cell depression
One of the drugs Ms. Smith will receive is cisplatin. Which of teh following is a nursing implication associatied with this particular drug?
IV hydration and mannitol diuretic therapy
Prophylactic antiemetic therapy
Monitoring of renal function
an example of palliative surgery is a
cordotomy
Bacille Calmette-Guerin (BCG) is a biologic response modifier that is a standard form of treatment for cancer of the:
bladder
An adult client is receivinlg radiation therapy. The nurse is teaching ther client about signs of radiation-induced thrombocytopenia, which cinclude
a tendency to bruise easily.
Clilents with decreased platelet counts (thrombocytopenia) have a tencency to bruise easily.
xerostmia
a dry oaral cavity caused by dysfunction of the aslivary glands
You are taking care of Ms. Smith the day that she receives her first chemotherapy treatment. Which of the following interventions is Not indicated.
Isolation from other patients ot prevent cross contamination is not necessary. Precautions (including gowns and gloves) when handling drugs and excreta are necessary. all contaminated equipment should be considered hazardous waste
the ratinale for the effectiveness of radiation therapy is its ability to
cause cell death; break the strands of the DNA helix; interrupt cellular growth when a nonsurgical approach is needed
the nurse should assess a cancer patient's nurtitional status by:
weighing the patient daily
The nurse is caring for a client who is receiving radiation therapy. Which activity by the client indicates he does NOT understand the side effects of rediation therapy?
Taking his childeren to see Santa at the mall.
People being treated wiht rediation therapy should avoid crowds because of the increased risk of infection. Crowds at Christastime can be very large and children are frequent carriers of infection. Use of an electric razor would be preferable to using a safety razor because of the danger of cutting the skin and causing prolonged bleeding due to the thrombocytopenia. The client should eat a igh-protein diet. The client should call his coctor for a temperature of 101 F
invasion
the growth of the primary utmor into surrounding host tissues in a variety of ways.
As a cause of death in the US, cancer ranks
2nd
radiation therapy for the treatment of cancer is administered ofer several weeks to :
allow time for the repair of healthy tissue
The most common cause of bleeding in cancer patients is
thrombocyotpenia
The priority nursing intervention for a cancer patient receiving chemotherapy postoperatively is ?
Mainta ing the comfort of the postoperative cancer patient through positioning and pain management is the priority nursing intervention.
matastasis
direct spread of tumor cells to body cavities or through lympatic and blood circulation
Cancer mortality in the US is highest among
African Americans
A patient with uterine cancer is being treated with internal radiation therapy. A primary nusing responsibility is to:
explain to the patient that she will continue to emit radiation for approximately 1 eek after the implant is removed
the most frequently occurring gram-postive cause of infection in cander patients is:
Staphylococcus
The nurse observes an abnormallu low serum sodium level in the client with oat cell carcinoma of the lung. Upon further investigationm, the nurse notes an increase urinary sodium, and a ten pound weight gain of the client in two days, the nurse reports these findings to the physician and suspects the client is experencing:
SIADH (Syndrome of inappropriate antidiuretic hormone)
Cells excrete ADH causing the disorder. A dilutional hyponatremia is caused by increased fluid volume which would cause weight gain. Consequently, the body attempts to compensate and rid the body of the excess volume by excreting sodium.
carcinoembryonic antigen (CEA)
prostatespecific antigen (PSA)
two significant tumor-specific antigens present in cancer cells that help with diagnosis and treatment
The etiology of cancer can be associated with specific agents or factors such as
dietary and genetic factors
hormonal and chemical agents
Viruses
a major disadvantage of chemotherapy is that it:
targets normal body cells as well as cancer cells
anaplasia
cells that lack normal cellular characteristics and differ from other cells in shape and organization. Anaplastic cells are usually malignant
The nurse recongnizes the person at highest risk of developing prostate cancer is?
Cancer of the prostate is rare before the age of 50, but increased with each decade. Black men develop it twice as frequentlyl as caucasian men andd at an earliler age
primary prevention
concerned with reducing the risk or preventing the development of cancer in healthy people
Cancer cells can affect the immune system by:
stimulating the release of T lymphocytes into the circulation
suppressing the patient's natural defenses
mobilizing macrophages
Mrs. Jones is crying when you enter the room and tells you she is very frightende. Your nmost appropriate response would be (r/t cancer)
"I can see that you're very upset. Let's talk abut some of your concerns." Encouraginv the venting of fears and concerns assists the client to verbalize anxiety.
secondary prevention
involves detection and screening effors to achieve early diagnosis and prompt intervention to halt the cancerous
In teaching Mrs.Jones about external radiation therapy, your instructions would include?
External beam therapy is administered daily over a period of weeks. Actual treatment lasts onlyl a few minutes.
cure
implies complete eradicatiomn of malignant disease
As part of your teaching regarding skin casre, you would tell Mrs. Jones to:
Tight-fitting clothing should be avoided to protect the fragile skin from further irritation. Lotions, soap, and powder should not be applied to the treatment area without physician approval.
control
strives for prolonged survival with the presence of malignancy
In addition to combination chemotherapy with intravenous drugs, Johbn will also receive intrathecal methotrexate for lymphoblstic leukemia. This drug will be giben inlto the?
Intrathecal drug administration refers to drugs given directly into the spinal fluid to treat leukemic infiltration of the brain.
p;lliation
implies relief of symptoms associated with the cancerous disease
John is engaged and was planning on being married when he graduated college. He and his fiance ask you about the reproductive consequences of chemotherapy. Which of the following is the nost appropriate statement concering the reproductiv eeffects of chemotherapy?
Sperm banking is an option for future procreaton. Contraception is still necessary; sterility is a potential, but is not guaranteed. Impotence refers to imparied eractile function, not sperm production
staginh of tumor cells
tumor size and existence of metastasis
grading
tumor cell classificaton
cachexia
appetite failure resulting in a wasting syndrome
radiation therapy side effects of skin
alopecia, erythema, desquamtion
radiation therapy side effects of oral mucosal membrane
werstomia, stmatitis, dicreased salivaiton,lossof taste
radiation therapy side effects of stomach or colon
anorexia, NV, diarrhea
radiation therapy side effects of bone marrow-rpoducing sites
anemia, leukopenia, and thrombocytopenia
kim's husband refuses to paricipate in any discussion about his wife's diagnosis (breast cancer). the nurse realizes that he is using the defense mechanism of
denial
postoperatively, Kim esperiences sever incisional pain. The nurse realizes that Kim;s percepton of pain is possibly influenced by
tissue manipulation during surgery; anger stemming from her change in body image; apprehension regarding the prognosis of her condition
Kim is scheduled to begin radiation therapy: relizing the side effects of radiation therapy, the nuse should prepare KIm for
her lungs may possibly produce more mucus; she may tire more easily and require additional rest periods; the skin at the treatment area may become red and inflamed
The nurse should teach Kim what she can do to protect her skin between radiation treatment. measures include
handle the area gently; aboid irritation with soap and water; wear loose-fitting clothing
After three weeks( radiation treatments) Kim develops a fever, sore throat, and cold symptoms. The nurse knows that Kim's symptoms could be due to
bone marrow depression, altered nutrition, leukopenia
nursing assessment during Kim's chemotherapy includes observing for (after rediation)
evidence of stomatitis, symptoms of infection owing to granulocytopenia, renal and hepatic abnormalities
Kim is diagnosed as having thrombocytopenia. The nurse should assess for
hematuria, hematemesis, ecchymosis
the nurse will assess for the postoperative complication of septic shock which is associatied with
oliguria, metabolic acidosis, dysrhythmias
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