Cancer
When is Adjuvent therapy administered?
It is administered after surgery or radiation to kill remaining cancer cells
You just assisted in an intubation, right off the bat, how do you confirm tube placement?
End title CO2
How does Morphine improve breathing?
By acting on the central nervous system to alter the brain's perception of air hunger, slowing rapid/shallow breathing and allowing for deeper breaths.
How do steroids positively impact spinal cord compression?
Your patient is in their Nadir Period and has been running fevers. You delegate your PCA to temperature checks. Where would you tell your PCA not to obtain a temperature from?
Rectal.
Reduces the risk of rectal tears, allowing bacteria to enter the blood stream, and cause infection.
When is Neoadjuvent chemotherapy administered?
It is administered shrink tumor before surgery or radiation
Why would a low pressure alarm go off on a vent?
Disconnected, Self Extubation, Cuff Leak, Tube migration.
Your patient is complaining about SOB what are two immediate things the RN can do before calling for assistance.
Elevate HOB and apply/increase O2
You notice your full code lung cancer patient has periorbital and upper extremity edema. As his nurse what is your top priority assessment?
Airway/Breathing
What can happen if the ET tube cuff is over inflated?
Tracheal tissue necrosis
Your patient is in their Nadir Period, what food is contraindicated? (select all that apply)
A. Blanched vegetables
B. Over easy eggs
C. Well done hamburger
D. Italian Sandwich
B. Over easy eggs
D. Italian Sandwich
What would be some reasons the high pressure alarm would go off?
Biting tube, Mucus plug, Kinked tube
When suctioning a patients airway the nurse may accidentally stimulate the Baroreceptor Reflex or the Vagal Nerve. How would you know this was activated, and what would you do?
Bradycardia
Stop suctioning
Your patient has small cell lung cancer and is now experiencing SIADH. As their nurse you know that frequent assessment of which lab value is important?
Sodium
Your patient has cancer, they are asking if they can receive the influenza vaccine. What is your answer?
Yes, your patient can receive immunizations, they just can not be live attenuated vaccines.
Reed Sternberg Cells are only present with which malignancy?
Hodgkins Lymphoma.
What is the difference between CPAP and BIPAP?
CPAP delivers a single, constant, fixed pressure to keep airways open.
BiPAP provides two distinct pressure levels—higher for inhalation (IPAP), lower for exhalation (EPAP)
What is the purpose of PEEP?
To use positive pressure to open up collapsed alveoli.
Your multiple myeloma patient is experiencing hypercalcemia and is on a diuretic. Which diuretic would be most likely prescribed.
1. Hydrochlorothiazide
2. Lasix
3. Spirolactone
2. Lasix
*lasix over thiazide diuretics
What are some treatments of TLS. (give 2)
Aggressive Hydration, Rasburicase, Allopurinol, Lokelma
Where is intrathecal chemotherapy administered?
Into the subarachnoid space, directly to the CSF.
A patient's arterial blood gas measurements read:
pH = 7.29, PaCO₂ = 47 mmHg, and HCO₃ = 24 mEq/L. How would you interpret this?
RESPIRATORY ACIDOSIS.
How does proning assist in ARDS?
It improves oxygenation by reducing lung compression from the heart and abdomen, allowing collapsed dorsal lung regions to reopen
In Tumor Lysis Syndrome, which lab values can assist in diagnosis.
Hyperkalemia, hyperuricemia, hyperphosphatemia, and hypocalcemia.
Which teaching is essential for a patient receiving internal radiation (brachytherapy)?
The patient must be in a private room, and all visitors must remain at least 6 feet away and limit visits to 30 minutes.