Onco Emergencies
Categorize what causes each of the 4 oncological emergencies between the two options
Tumor block or Hormone change
1. spinal 2. tumor lysis 3. superior vena cava syndrome 4. hypercalcemia
hormone change - tumor lysis and hypercalcemia
Bleeding is common in Crohn's disease T or F
F
RA affects what gender and what age most?
30-50, 50-70, or 70-80?
Female, 30-50
Name 2 contributive factors of lupus
genetics
female
excessive sun exposure
infection
Name 2 med classes to treat UC or Crohn's
Antimicrobials
Corticosteroids
Immunomodulators
5-aminosalicylates
Which option is the gold standard for diagnosing superior vena cava syndrome?
1. CT
2. MRI
3. Lab values
MRI
Between UC & Crohn's, which disease affects patches of the intestine?
Name one specific rheumatoid arthritis lab result
rheumatoid factor
antinulear antibody (ANA)
cpp test
elevated esr and crp
What is Raynaud syndrome?
blue/purple/pure white finger tips
Bio- stops calcium from leaving bone
Calcitonin- slows bone loss and also keeps calcium in bones
note: They inhibit osteoclast activity in bone
List 2 nursing cares for patient with spinal cord compression (med administration not accepted)
-skin care
-escort them while walking
-gait belt
-no twisting or bending
-teach patient to log roll out of bed
-thorough assessment - heaviness? difficulty walking?
list 3 goals of care for UC and/or Crohn's
-nutritional support
-maintain fluid/electrolyte balance
-avoid skin breakdown
-education (diet)
2 nursing cares for RA
-promote muscle strength (ROM)
-promote mobility (walking)
-promote comfort
-thermotherapy
-teach about meds
Name 2 main manifestations of lupus
-butterfly rash
-alopecia
-joint pain
-mouth ulcers
Name 1 med to treat tumor lysis
1. Lasix -potassium wasting
2. Kayexalate -slowly removes potassium thru bowel movements
3. Allopurinol -uric acid removal
Calcium >12 and aggressive hydration is reversal method (+ loop diuretic use)
What side does UC usually affect and what side does Crohn's usually affect?
Cohn-lower right
UC-lower left
List 3 clinical manifestations of RA
-pain in 1 or more joints
-weight loss
-weakness
-joint swelling
-Raynaud
-Joint tenderness
Which of theses drugs induce lupus?
isonaizid
hydroxychloroquine
Celecoxib
procainamide
isonaizid
hydralazine
procainamide
Can thiazide diuretics be used to treat hypercalcemia? AND WHY ???
No, because they increase calcium absorption
Explain cause of tumor lysis and what is the biggest risk involved?
We caused it with chemo/radiation. Content of destroyed cells are let into system leading to excess of things like potassium, uric acid, phosphate, etc. Biggest risk is kidney failure leading to death
describe the step up and step down approach
step up - patients with mild symptoms will begin with medication when initial therapies do not work.
step down - patients will use immunosuppressants and biological therapies first.
For RA to be diagnosed, there must be at least 4/7 specific s/s. What are four of the seven?
1. Morning stiffness > than 1hr
2. Swelling in 3 or more joints
3. Swelling in hand joints
4. Symmetrical joint swelling
5. Erosions/decalcification on x-ray
6. Rheumatoid nodules
7. Rheumatoid factor positive
Name 3 nursing cares for lupus
avoid sun
avoid infection risks
maintain balance diet
meds (methotrexate)
avoid emotional and physical stress
Name 2/3 of the general autoimmune disorder medications from the PPT
DMARDS, TNF inhibitors, Corticosteroids