Sepsis/Septic Shock
DIC/TTP
Anaphylaxis
Obstruc/Extrav
Pneumonitis
100
Systemic Inflammatory Response Syndrome (SIRS) + infection = A. Septic Shock B. Sepsis C. MODS D. SIRS2
What is sepsis?
100
Name the two most common causes of DIC. A. colon cancer and fever B. leukemia and infection C. leukemia and fever D. leukemia and anticoagulants
What are leukemia and infection?
100
Define hypersensivity reaction. A. A sudden, overwhelming, systemic allergic reaction to an antigen or foreign body to which the body is exposed B. Immunologic response to an antigen or foreign substance to which the body is exposed
What is immunologic response to an antigen or foreign substance to which the body is exposed?
100
Define extravasation. A. Inflammation or irritation of the skin around an infusion site. B. Erythema, pruritis, and localized urticaria at or adjacent to the site of infusion C. Escape of chemotherapy drug into extravascular space by leakage from vessel or direct infusion
What is escape of chemotherapy drug into extravascular space by leakage from vessel or direct infusion?
100
Tests used in diagnosis of pneumonitis.
What are • Chest X-ray • CT • Pulmonary Function Tests • Bronchoscopy • Lung Biopsy
200
Most common source of infection-related sepsis A. Gram positive bacteria B. Gram negative bacteria C. Spirochete D. Spirillum
What is Gram negative bacteria (E Coli, Klebsiella pneumonia, pseudomonas aeruginosa)?
200
What are the alterations in lab values that are expected for a patient with DIC? A. decreased PT/PTT, decreased FDP & FSP, and increased Hgb, Hct, platelets & fibrinogen B. hyperkalemia, hyponatremia C. increased PT/PTT & FDP & FSP; decreased Hgb, Hct, platelets, & fibrinogen D. hypermagnesemia, hypernatremia, hypokalemia
What are increased PT/PTT and FDP & FSP and decreased Hgb, Hct, platelets, & fibrinogen?
200
What is anaphylaxis? A. An immunologic response to an antigen or foreign substance to which the body is exposed B. A sudden, overwhelming, systemic allergic reaction to an antigen or foreign substance to which the body is exposed
What is sudden, overwhelming, systemic allergic reaction to an antigen or foreign substance to which the body is exposed (Type I hypersensivity reaction)?
200
List factors that affect degree of tissue damage from extravasation.
What are Type of vesicant Concentration & amount of vesicant in tissue Location of extravasation Patient factors ?
200
Pharmacologic Treatment for pneumonitis.
What are • Corticosteriods • Antibiotics • Oxygen therapy • Bronchodilators
300
List 5 symptoms of septic shock.
What are fever, chills, tachycardia, tachypnea, mental status changes, hypoperfusion, hypotension that persist despite agressive fluid challenge?
300
What is the best treatment for DIC? A. Fluid replacement for hypotension & proteinuria B. Oxygen therapy for hypoxia & acidosis C. Blood product(s) infusion D. Treat the underlying cause
What is correct the underlying cause?
300
Name 3 chemotherapies commonly associated with anaphylaxis.
What are L-asparaginase, Taxanes (Paclitaxel, Docetaxel), Platinum compounds (Cisplatin, Carboplatin, Oxaliplatin), Epipodophyllotoxins (Etoposide & Teniposide)?
300
Patients with which cancer diagnoses commonly experience bowel ostruction as a complication. A. brain, bladder, breast B. leukemia, ovarian, stomach C. colon, stomach, ovarian D. bladder, colon, breast
What are colon, stomach, ovarian?
300
Signs & symptoms of pneumonitis.
What are • Shortness of breath • Cough • Fatigue • Loss of appetite • Unintentional weight loss
400
List 6 elements of treatment for septic shock
What are hemodynamic support, blood component therapy, vasopressors & inotropic support, oxygen therapy, treatment of infection, & supportive therapies?
400
What are the treatment methods for Thrombotic Thrombocytopenic Purpura? A. Treat the underlying cause B. RBC transfusion, steriods, plasmaphoresis C. Plasmaphoresis, steriods, platelet transfusion D. Chemotherapy, radiation, steriods
What are plasmaphoresis, steroids, and platelet transfusion?
400
Name medications used for respiratory and cardiovascular management of anaphylaxis.
What are beta-agonist for bronchospasm, epinephrine, corticosteroids, crystalloid IV solution (NS, LR), benadryl, vasopressors, antiarrhythmics?
400
Name treatments for bladder obstruction.
What are catheter, suprapubic catheter, surgery, steroids, antimicrobials, Flomax?
400
Teaching for a patient with pneumonitis.
What are • Teach patients to prioritize daily activities. • Teach patient to use breathing techniques such as pursed lip breathing. • Teach effective cough and deep breathing techniques.
500
Name two variables that define SIRS.
What are fever >38 C or <36 C, Heart rate > 90 bpm, respiratory rate >20 breaths per minute, PaCO2 >32 mm Hg, WBC count >12,000/uL or <4,000/uL or > 10% bands?
500
Name the best way to differentiate DIC from TTP.
What is TTP patient is disoriented & confused and DIC patient is not?
500
List nursing interventions to perform at first sign of anaphylaxis.
What are stop infusion of allergen, maintain normal saline infusion, evaluate & maintain airway, take vital signs, notify PCP, administer emergency medications as ordered or per protocol?
500
Name the principals of medical management for extravasation.
What are • STOP infusion!!! • Attempt to aspirate remaining drug from catheter • Estimate amount of extravasated drug • Remove peripheral IV or port needle • Assess site & symptoms • Elevate affected arm • Apply ice or warm compress • Notify physician • Antidotes and/or appropriate management measures (ONS Chemotherapy & Biotherapy Guidelines & Recommendations for Practice) • Photograph site & document
500
Name three chemotherapies prone to extravasation and their antidotes.
What are o Dexrazoxane for anthracycline extravasation o Hyaluronidase for plant alkaloids o Sodium thiosulfate for mechlorethamine
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