Rare but Real
What is infection?
This is a common side effect of chemotherapy that affects the bone marrow.
What is myelosuppression?
Severe hypoxemia that is unresponsive to oxygen is a hallmark symptom of this respiratory disorder.
What is acute respiratory distress syndrome (ARDS)?
This type of shock is IgE-mediated.
What is anaphylactic shock?
DAILY DOUBLE!
Q: A neutropenic patient with leukemia is being discharged. Which instruction is the priority?
A) Take your temperature once a day
B) Avoid public transportation
C) Brush teeth twice daily with a soft toothbrush
D) Report any fever over 100.4°F immediately
Neurologic symptoms are common with this type of anemia.
What is Vitamin B12/pernicious anemia?
Bowel or bladder dysfunction combined with weakness and pain along a dermatome may indicate this oncologic emergency.
What is spinal cord compression?
Following thoracic surgery, absent breath sounds may indicate this complication.
What is a pneumothorax? (Will also accept hemothorax)
This lab value indicates early sepsis.
What is elevated serum lactate? (Normal value: 0.5-1.7 mmol/L)
A patient with aplastic anemia is receiving care on the medical-surgical unit. This intervention is the nurse's priority.
A) Monitor for signs of infection
B) Encourage protein intake
C) Administer scheduled stool softeners
D) Assist with ambulation
What is A- monitor for signs of infection?
DAILY DOUBLE!!!
Q: This temperature reading defines a medical emergency in neutropenia.
Facial swelling and neck vein distention are classic signs of this oncologic emergency.
What is superior vena cava syndrome?
These ABG results suggest acute respiratory failure.
What is a PaO2<60 (hypoxemia) OR PaCO2 > 50 (hypercapnia) with pH < 7.35 (acidosis)?
The tissue hypoperfusion seen in all types of shock is only complicated by the activation of this cascade.
What is the clotting cascade? (We will also accept coagulation cascade.)
This nursing intervention is the highest priority for a hospitalized patient with advanced HIV and a CD4 count of 90.
A) Encourage oral fluids
B) Provide small, frequent meals
C) Maintain protective isolation
D) Perform daily weights
What is C- maintain protective isolation? (CD4 count < 200 indicates severe immunosuppression?
What is 20,000/mm3?
Tumor lysis syndrome commonly leads to these four electrolyte imbalances.
What are hypocalcemia, hyperkalemia, hyperphosphatemia, and hyperuricemia?
This is the most common cause of a lung abscess.
What is bacterial pneumonia?
Tachycardia and warm, flushed skin are early clinical signs of this type of shock.
What is septic shock?
The nurse is caring for a patient with systemic lupus erythematosus (SLE). This finding requires immediate action.
A) Joint pain
B) Facial rash
C) Hematuria
D) Fatigue
What is C- Hematuria? (may indicate lupus nephritis)
This can be given prophylactically to prevent bleeding in patients with Von Willebrand disease.
What is desmopressin?
A patient receiving chemotherapy reports fatigue, constipation, and confusion. The nurse suspects this oncologic emergency.
What is hypercalcemia?
This acronym helps nurses remember the interventions to prevent atelectasis. (*Note you only get credit if you know what the acronym stands for)
What is ICOUGH? (Incentive spirometer, cough and deep breathing, oral care twice/day, understanding, get out of bed three times per day, and head of bed elevated)
A patient presents with cool, pale skin, decreased urine output, confusion, and the following vital signs: BP 110/62, P 110, R 24, SpO2 93%, T 98.7F.
The patient is likely experiencing this stage/phase of shock.
What is the compensatory stage/phase?
A patient with advanced HIV (CD4 count 85) presents with a new nonproductive cough, fever, dyspnea on exertion, and normal chest auscultation. This nursing action is most urgent?
A) Administer prescribed antipyretic
B) Monitor oxygen saturation
C) Notify the provider of possible Pneumocystis pneumonia (PCP)
D) Encourage incentive spirometry
What is C- notify the provider of possible PCP?
(PCP is an opportunistic infection common in advanced HIV. The normal auscultation can delay recognition — early intervention is critical.)