Lung Cancer
Breast Cancer
Lab Values
Leukemia
DIC
100
A 20 year old male with a history of tobacco use presented with a cough for over 3 weeks, lower back pain, weight loss of over 11.3kg, hemoptysis. This is one of the imaging studies that the physician ordered
What is a chest CT
100
Christina a 35 year old woman found a lump in her left breast while showering; the lump was painless, no skin changes, slowly enlarged over a 3 week time period. This is a risk factor associated with breast cancer
What is Hormone Replacement Therapy
100
This lab is drawn during when a patient is screened positive for sepsis and is required to be placed on ice.
What is lactic acid level.
100
48 y/o female presented to the emergency department with severe headaches, dyspnea on exertion, and petechiae on the lower extremities. WBC 56,000 Platelets 15 ANC 0.7 This procedure is done to determine disease progression and cell differentiation.
What is a bone marrow biopsy.
100
a 34-year-old male with a history of leukemia is being admitted to you from East ER with possible relapse. Patient was admitted around 1845. PIV was placed, labs drawn around 1100 the same day. Pt. VS: T 99.1, HR 135, RR 22, O2 Sat 94% on 2L, BP 144/78. WBC 189.00 Hgb 14.5 Plt 48 61% blast PT 23.1 INR 2.06 PTT 47.9 Fibrinogen <60 D Dimer >20 CMP WNL What are some other signs and symptoms the patient may present with (think about low platelet count and other lab values)
What is ecchymosis on extremities, patient is at risk for bleeding.
200
The Chest CT shows a right sided mass, the patient is then told of suspicion of lung cancer. The next steps requires a procedure to get a visual of the lungs and biopsies for further testing
What is a bronchoscopy
200
On examination findings were: 2 cm mass on left breast, no palpable lymphadenopathy. This should be organized immediately for Christina
What is mammogram or ultrasound
200
This test is performed on a client with Leukemia before initiation of therapy to evaluate the client's ability to metabolize chemotherapeutic agents.
What are liver function tests.
200
The patient's bone marrow biopsy comes back showing ALL with 90% blasts. She receives chemotherapy and few days later presents with Uric Acid 12, K 6.2, Phos 4.9, Calcium 7.8. These imbalances can cause toxicity and eventually organ failures. Which onc emergency?
What is TLS
200
The main concern at this point would be
What is monitor for DIC
300
Histology report shows that the patient has small cell carcinoma. This is true about the spread of SCLC at the time of diagnosis
What is 80-90% of SCLC have spread beyond the thorax at the time of diagnosis
300
The patient and physician concluded on treatment option after results from the fine needle biopsy came back. This treatment option provides adequate local control
What is a simple mastectomy with axillary node clearance.
300
What is the client experiencing with the following lab values: Potassium 2.9 pH 7.46 bicarbonate 29 mEq/L
What is metabolic alkalosis
300
What are some interventions for TLS?
What are IV hydration, allopurinol, diet modified to be low in phosphate and potassium, phosphate binders (sevelamer, calcium carbonate), calcium gluconate (severe hypocalcemia and hyperkalemia), Kayexalate, IV insulin, Sodium Bicarbonate, dialysis, minimizing drugs that can cause renal toxicity.
300
Some important interventions are:
What is Monitor patient for signs and symptoms of bleeding, initiate bleeding precautions, educate patient about risk for injuring themselves and calling for help prior to getting out of bed. Monitor labs, monitor VS (In DIC patient's BP can drastically drop at any time)
400
The patient is treated with chemotherapy and does well with the treatment. 7 months after completion of chemotherapy the patient presents to the ER with increasing SOB, exercise intolerance, decreased oxygen saturation, paleness. This is the most common cause of the patient's signs/symptoms
What is anemia
400
Since that patient and physician has agreed upon a radical mastectomy and removal of any lymph node involvement, you anticipate that the patient will need support and teaching on this
What is body image and sexuality
400
This laboratory result would be noted specifically in a client diagnosed with multiple myeloma.
What is an increased in calcium level.
400
Three weeks later she returns from home with a high grade fever and dehydration. You notice upon assessment her VS are as follows: BP 82/45, RR 28, T 102.9, HR 135, O2 89% on RA. The patient is experiencing signs and symptoms of
What is Sepsis
400
The physician is made aware of patient's labs, you can expect to receive what type of orders?
What are there are no specific treatments for DIC but treating the underlying cause is important and include supportive care, which are orders for transfusions such as platelets, FFP, Cryo.
500
Patient's labs come back as Hgb 6.2, Hct 22.5, platelets 10. The patient's oxygen saturation drops to 75% on room air, HR is 120. Treatment plan for this patient is
What is supplemental oxygen, platelet and packed red blood cells transfusion.
500
The patient will also need chemotherapy, she receives her first dose of chemotherapy last night and begins to have nausea and vomiting. You know that there are precautions when handling bodily fluids form someone who receives cytotoxic treatments, these precautions include
What is double gloving, PPE if needed, placing linens in green linen bag
500
PT 25.9 INR 2.98 Fibrinogen 80 Platelets 20 APTT 22.5 These labs are indication of
What is DIC
500
After the patient's VS and assessments are documented the system fires this notification and the nurse must now complete ____________, and notify these 3 personnel of the patient's status.
What is sepsis alert, sepsis monitoring tool, charge nurse, rapid response team, and physician.
500
What are some complications from DIC?
What is bleeding, stroke (blood is clotting too much), lack of blood flow to limbs and vital organs.
M
e
n
u