Cancer
What med can be used to stimulate RBC production and used with oncology patients?
What is Epoetin alfa (Epogen or Procrit)
Expressed by feelings of elation, inflated self-esteem, grandiosity, hyperactivity, agitation and accelerated thinking and speaking.
What is mania
The nurse is implementing interventions for the client who has increased ICP. The nurse knows that which result will occur if the increased ICP is left untreated? ---------------------------------------------------------- a. Displacement of brain tissue b. increase in cerebral perfusion c. increase in serum pH level d. Leakage of CSF
What is a. ------------------------------------------------------ Increased ICP causes a shift in brain tissue and can result in irreverible brain damage and possible death. Decreased perfusion, decrease pH (acidosis). No indication of trauma (leakage would occur in an opening in the subachnoid space).
The combination of physical emotional and spiritual depletion associated with caring for patients in significant emotional pain and physical distress
What is compassion fatigue
Which cranial nerve controls facial movements and expression... Bonus 100 points: How do you assess for this nerve's function (at least 3)?
What is the facial nerve (CN VII). Assess the patient for facial symmetry. Wrinkle forehead, close eyes, smile, pucker lips, show teeth and puff out cheek
What is one of the most significant and frequent symptoms experienced by patients receiving cancer therapy?
What is fatigue
True or False: Projection is a major defense mechanism
What is True
The client develops SIADH secondary to a pituitary tumor. The client's assessment findings include thrist, weight gain, fatigue and a serum sodium of 127 mEq/L. Which intervention, if prescribed, should the nurse implement to treat SIADH? ------------------------------------------------------------ a. Elevate the head 30 degrees. b. Administer vasopressin IV. c. Restrict fluids to 800-1000 mL/day. d. Give 0.3% sodium chloride IV infusion.
What is c. ------------------------------------------------------------------ If symptoms are mild and serum sodium is greater thatn 125 mEq/L, treatment includes fluid restriction to 800-1000mL/day and discontinuation of meds that stimulate the release of ADH. The fluid restriction should result in a progressive rise in serum sodium concentration and osmolality and symptomatic improvement. ---------------------------------------------------- Bed should be flat or no more than 10degrees of elevation to enhance venous return to the heart and increase left atrial filling pressure, reducing ADH release. Vassopressin is an ADH. Hypertonic saline 3-5% should be administered if hyponatremia is severe (<120 mEq/L)
Thirty people are injured in a train derailment. Which client should be transported to the hospital FIRST? 1. A 20 yr-old who is unresponsive and has an injury to his cervical spine 2. An 80 yr-old with a compound fracture of the left arm 3. A 10 yr-old with a laceration on his right leg 4. A 25 yr-old with a sucking chest wound
What is 4
4. A 25 yr-old with a sucking chest wound
A nurse is assessing a client who sustained a basal skull fracture and notes a thin stream of clear drainage coming from the client's right nostril. Which of the following actions should the nurse take first?
A. Test the drainage for glucose.
B. Suction the nostril.
C. Notify the physician.
D. Ask the client to blow his nose.
Test the drainage for glucose.
Answer Rationale:
This is the priority nursing action. Because of the high risk of cerebral spinal fluid (CSF) leak in clients with basal skull fractures, the nurse should realize there is a possibility that the clear fluid coming from the client's nostril is CSF, which will test positive for glucose.
If a woman shows signs of breast cancer or has a positive mammogram, which diagnostic test should be performed?
What is either a diagnostic ultrasound or diagnostic mammogram with biopsy is recommended.
Daily Double!!
Polyuria, Increased tremors, muscular irritability, psycho-motor retardation
What is moderate Lithium Toxicity? (2.0-3.5 meq/L)
Daily Double!
The nurse is administered mannitol IV to decrease the client's ICP following a craniotomy. Which laboratory result should the nurse monitor during the client's treatment with mannitol? --------------------------------------------------------------- a. Serum osmolarity b. WBC's c. Serum cholesterol d. ESR (erythrocyte sedimentation rate)
What is a. ---------------------------------------------------------------- Mannitol is an osmotic diuretic. It increases the serum osmolarity and pulls fluid from the tissues; thus decreasing cerebral edema postop. Serum osmolarity levels should be assessed as a parameter to determine proper dosage. All the other labs are not affected by mannitol.
A middle-age man collapses in the ED waiting room. What should the triage nurse do FIRST? 1. Gentle shake the victim and ask him to state his name 2. Perform the head-tilt chin-lift to open the victims airway 3. Feel for any air movement from the victims nose and mouth 4. Watch for chest rise
What is 1.
1. Gentle shake the victim and ask him to state his name
A nurse is caring for a client who has a traumatic brain injury. Which of the following findings should the nurse identify as an indication of increased intracranial pressure (ICP)?
A. Taccycardia
B. Amnesia
C. Hypotension
D. Restlessness
Restlessness
Answer Rationale:
Increased intracranial pressure is a condition in which the pressure of the cerebrospinal fluid or brain matter within the skull exceeds the upper limits for normal. Signs of increasing ICP include restlessness, irritability and confusion along with a change in level of consciousness, or a change in speech pattern.
This condition results from a large number of tumor cells rupturing from chemotherapy or radiation, and they release their cell contents, causing hyperkalemia and high uric acid levels (total body gout). The signs are arrhythmias, severe pain, hematuria and it can cause death if severe/untreated. TX: IVF and sodium bicarbonate, dialysis, calcium chloride/gluconate, insulin & dextrose, kayexalate and allopurinal.
What is Tumor Lysis Syndrome
Causes of Bipolar disorder is not well understood but they say it is most likely cause by a A) Deep Depression B) Always being too optimistic C) Problem within the hippocampus D)problem with certain brain chemicals called neurotransmitters
What is D) problems with certain brain chemicals called neurotransmitters
The nurse is caring for the client who has severe craniocerebral trauma. Which finding indicates that the client is developing DI? ------------------------------------------------------------- a. Blood glucose level @ 230mg/dL b. Urinary output 1500mL over 4 hours c. Urine specific gravity @ 1.042 d. Somnolent when previously alert
What is b. -------------------------------------------------------------- The lack of ADH that occurs in DI results in excreting a large amount of pale, dilute urine. Elevated glucose are not associated with DI. Urine will have a very low specific gravity. Decrease in LOC not directly associated with DI but rather with craniocerebral swelling for bleeding from trauma.
Color tag in disaster triage which means immediate - Life Threatening Injury
What is Red colored Triage tag?
Green:Minor - Walking Wounded
Yellow: Delayed - serious, non life threatening
Black: Deceased - pulseless, non-breathing or not going to be able to save
When giving high flow oxygen (if possible) to an alert and responding patient with hypothermia the oxygen should be... (2 things)
What is warmed and humidified
N/V, alopecia, mucositis, oral ulcers, nephrotoxicity, thrombocytopenia, anemia
What are common complications of chemotherapy
The goal of this treatment modality is to identify and change the patient's negative generalizations and expectations to hopefully reduce symptoms of bipolar disorder.
What is cognitive therapy?
The nurse is assessing the child for possible increased ICP following head trauma. Which MOST important assessment finding associated with ICP should the nurse report to the HCP? ---------------------------------------------------------- a. Increasing temperature. b. Widening pulse pressure. c. Increased heart rate. d. Decreasing systolic pressure.
What is b. ------------------------------------------------------------------ A widening pulse pressure (increase in SBP and decrease in DBP) is one of the signs of Cushing's Triad and is indicative of IICP. Fever - ?infection. Bradycardia, not tachycardia is a sign of IICP. Increased systolic, not decreased, is a sign of IICP
Several clients have come to the ED after a possible bioterrorist act with arsenic exposure. The nurse should assess these clients for which signs and symptoms immediately following their arrival? SELECT ALL THAT APPLY 1. Violent vomiting 2. Severe diarrhea 3. Abdominal pain 4. Sensory neuropathy 5. Persistent cough
What is 1, 2, 3
1. Violent vomiting 2. Severe diarrhea 3. Abdominal pain
Name two ways heat is lost (think science)
What is conduction, convection, evaporation, respiration