What! Part 9!
Cells with Rapid Rate of Proliferation:
Bone marrow stem cell:
Generation time: ___
Effect of cell destruction: ___
1. Generation time: 6 - 24 hours
2. Effect of cell destruction: Myelosuppression (infection, bleeding, anemia)
This type of care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family.
Palliative care
Hospice care
These donors donate only a portion of the liver
Live donors
Signs and symptoms of otitis media (middle ear infection)
1. Pain
2. Fever
3. Malaise
4. Reduced hearing
5. Referred pain (teeth, gums, sinuses, throat)
Cells with Rapid Rate of Proliferation:
Neutrophils:
Generation time: ___
Effect of cell destruction: ___
1. Generation time: 12 hours
2. Effect of cell destruction: Leukopenia, infection
Some side effects of chemotherapy can fall into 1 or more categories of side effects. Examples of this would be
Nausea and vomiting - both acute and delayed
This is part of the screening process for liver transplant
1. Confirm dx
2. Assess for other comorbid conditions that affect surgical outcome
3. Evaluate labs, physical exam, cardiac and pulmonary statuses, physiological testing
Liver transplant:
These are the postop complications the recipient may experience
1. Bleeding
2. Infection
3. Rejection (the risk of rejection of liver is lower than kidney risk of rejection)
Medications that are HIGH RISK for ototoxicity
1. Antibiotics
A. Gentamicin
B. Streptomycin
C. Tobramycin
2. Loop diuretics
3. Chemo drugs
A. Cisplatin
B. Carboplatin
C. Vincristine
4. NSAIDs
5. Aspirin
Cells with Rapid Rate of Proliferation:
Epithelial cells lining the GI tract:
Generation time: ___
Effect of cell destruction: ___
1. Generation time: 12 - 24 hours
2. Effect of cell destruction: Anorexia, mucositis (including stomatitis, esophagitis), N/V/D
Chemotherapy side effects are the result of the destruction of normal cells, especially those that re rapidly proliferating such as those in the bone marrow, lining of the GI system, and integumentary system (skin, hair and nails)
Liver transplant:
These are the possible risks to the donor
1. Biliary problems
2. Hepatic artery thrombosis
3. Wound infection
4. Postop ileus
5. Pneumothorax
Liver transplant:
Name some types of the various types of meds used for immunosuppressive therapy
1. Corticosteroids (prednisone)
2. Calcineurin inhibitor (tacrolimus)
3. Antiproliferative agent (azathioprine)
Signs and symptoms of macular degeneration
1. Blurred or darkened vision
2. Scotomas (blind spots in the visual field)
3. Metamorphopsia (distortion of vision)
Cells with Rapid Rate of Proliferation:
Cells of the hair follicle
Generation time: ___
Effect of cell destruction: ___
1. Generation time: 24 hours
2. Effect of cell destruction: Alopecia
This occurs during and immediately after drug administration and includes anaphylactic and hypersensitivity reactions, extravasation or a flare reaction, anticipatory N/V and cardiac dysrhythmias
These are the various types of complimentary therapies
1. Herbs and nutritional supplements (fish oil, ginger, Sam-e)
2. Movement therapies (yoga, Tai Chi)
3. Acupuncture
4. Massage
5. Imagery
6. Biofeedback
7. Melatonin
8. Music therapy
Liver transplant:
Common respiratory problems include
1. Pneumonia
2. Atelectasis
3. Pleural effusion
Signs and symptoms of detached retina
1. Flashes of light
2. Blurred or "sooty" vision, "floaters"
3. Sensation of particles moving in the line of vision
4. Delineated area of vision blank
5. Feeling of a curtain coming up or down
6. Loss of vision
7. Confusion
8. Apprehension
Cells with Rapid Rate of Proliferation:
Ova or testes:
Generation time: ___
Effect of cell destruction: ___
1. Generation time: 24 - 36 hours
2. Effect of cell destruction: Reproductive dysfunction
1. Delayed N/V
2. Mucositis
3. Alopecia
4. Skin rashes
5. Bone marrow suppression
6. Altered bowel function (diarrhea or constipation)
7. Variety of cumulative neurotoxicities
Explain the chronic toxicities of chemotherapy and when they occur
Involve damage to organs such as heart, liver, kidneys and lungs and can either be long-term effects that develop during or immediately after treatment and persist or they can be late effects that are absent during treatment and manifest later
These are the things you would teach a patient who is diagnosed with neutropenia
1. WASH YOUR HANDS frequently and make sure those around you do the same
2. Notify your nurse or HCP for:
A. Fever > 100.4
B. Chills or feeling hot
C. Redness, swelling, discharge or new body pain
D. Changes in urination or BMs
E. Cough, sore throat, mouth sores or blisters
3. If @ home, take temp as directed and report according to HCP instructions
4. Avoid crowds and people with colds, flu, or infections - If in public, wear mask and use hand sanitizer frequently
5. Avoid uncooked meats, seafood, eggs and unwashed fruits/veggies - ask HCP about food guidelines
6. Bathe and shower daily - moisturize skin to prevent drying/cracking
7. Maintain some daily activity as instructed by HCP (walking, etc.)
8. Brush teeth with soft toothbrush q.i.d. (may floss if no pain or bleeding, no alcohol-based mouthwash)
9. DO NOT garden or clean up after pets - okay to feed pets as long as you wash your hands after
Liver transplant:
Postop nursing care
1. Assess neuro status
2. Monitor for signs of hemorrhage
3. Prevent pulmonary complications
A. Cough
B. Deep breathe
C. IS (incentive spirometry)
D. Reposition
4. Monitor drainage from JP drain, NG tube and note color/consistency of drainage
5. Monitor electrolyte levels
6. Monitor urine output
7. Monitor for S/S of infection/rejection