CANCA
What are the 3 stages of cancer development?
Initiation, Promotion, Progression
Name the examples of isotonic, hypotonic, and hypertonic fluids and when would you use them
Isotonic - 0.9% NaCl (maintenance, blood loss, low BP) lactated ringers (maintenance, burns, GI loss) D5W (maintenance, carbs)
Hypotonic - 0.45% NaCl (hypernatremia, cellular dehydration), 0.225% NaCl (hypernatremia) MUST MONITOR NEURO
Hypertonic - 3% NaCl (brain swelling, hyponatremia), D5NS (hyponatremia, maintenance) MONITOR BP, LUNGS, NEURO
What are the normal ranges for pH, CO2 and HCO3
pH: 7.35-7.45
CO2: 35-45
HCO3: 22-26
What is the number one priority for urinary problems?
Pain
What is the best indicator of acute kidney injury
Serum creatinine
Name 3 warning signs of cancer
Change in bowel/bladder habits
A Lesion that doesn’t heal
Unexplained weight loss
Thickening or lumps
Indigestion or difficult swallowing
Obvious changes in moles or lesions
Nagging pain, cough
Explain the fluid balance regulation process in the case of FVE
Osmoreceptors detect FVE > hypothalamus tells pituitary to suppress ADH release > kidneys increase diuresis
Interpret this ABG: pH 7.49 CO2 24 HCO3 22 PaO2 105
Uncompensated respiratory alkalosis
Explain the pathway of the nephron
Glomerulus - site of initial filtration
Proximal convoluted tubule - returns 60-70% Na back to blood
Loop of henle - descending and ascending loop
Distal convoluted tubule - 5-10% Na reabsorbed & regulated by aldosterone
Collecting duct - ADH influences urine excretion
What is the indication of prerenal
Low perfusion or hypotension
Name the two cell cycle specific antimetabolites of chemo
Methotrexate & flurouracil
Explain the causes, manifestations, treatment, and assessment of hyperkalemia
Causes: renal failure, crush injury
Manifestations: tented T waves, wide QRS complex, no P wave, irritable/anxious, muscle weakness
Treatment: calcium gluconate, insulin w dextrose, bicarbonate, sodium polystyrene, sodium zirconium cyclosilicate
Assessment: cardiac monitoring, neuro, bowel sounds, muscle strength, dialysis
Interpret this ABG: pH 7.14 CO2 60.7 HCO3 15.3 PaO2 82.6
Mixed respiratory & metabolic acidosis
Name the classes of diuretics
CAIs, osmotic, loop, thiazides, potassium sparing
What is the diagnosis for chronic kidney disease
GFR <60 for 3 months or longer
What is extravasation & what do you do if it occurs?
Leakage of chemo into tissues causing nerve, tendon, or muscle damage
Stop the infusion, leave catheter in place, notify prescriber, document thoroughly
Causes of hypocalcemia
Hypoparathyroidism, chronic kidney disease, TLS, pancreatitis
What will a patient experience if they have respiratory acidosis?
Hypoventilation & respiratory failure > low BP, headache, hyperkalemia, dysrhythmias, hyperreflexia, drowsiness
Loop diuretics cause which adverse effects
Tinnitus, hypokalemia, myelosuppression, N/V/D, headache. & dizzy
What is the most common skin cancer
Basal cell carcinoma
Name the 3 indications of myelosuppression and the symptoms of each
Anemia (RBC, Hg, Hct) -pale skin & mucosa, fatigue, lethargy, SOB, diff concentrating, tachycardia
Leukopenia (WBC) - fever, chills, tachycardia, productive cough, purulent sputum, change in urine
Thrombocytopenia (Platelets) - petechiae, ecchymosis, gingival bleeding, blood in urine/stool, prolonged bleeding from IV
Name the causes, manifestations, treatment, and assessment for hyponatremia & hypernatremia
Hyponatremia: caused by excess free water, diuretic drugs, increase in ADH, GI loss, Addison’s disease; manifestations are confusion, coma, death, seizures, N/V/D; treatment is hypertonic fluid, fluid restriction, increase Na intake; assess neuro
Hypernatremia: caused by sweating, fever, dehydration, exercise, diabetes insipidus; manifestations are confusion, coma, death, seizures, thirst; hypotonic fluid, more free water; assess neuro, I&O, HR & BP
What is the main component associated with metabolic acidosis?
Kussmaul respirations
Which diuretic class has a BBW and what is it
Loop diuretics have a BBW for fluid & electrolyte loss (furosemide)
List all of the derm drugs
Neomycin
Silver sulfadiazine
Isotretinoin
Tretinoin
Clotrimazole
Florouracil