Tumor lysis syndrome
Which type of medication can be given to promote urinary excretion of phosphate and potassium in the urine?
diuretics
What are the types of bone marrow transplants?
1. autologous- bone marrow removed from an individual for personal use.
2. allogenic-bone marrow came from someone else. There are 3 types of allogenic donation. They are:
syngeneic- donation from the patient's twin
related- donation from a relative usually a sibling
unrelated- donation from a nonrelative
What does pain usually indicate?
What type of diet should patients with cancer follow to minimize weight loss and promote healing?
Small frequent high protein, high calorie foods
What are the common concerns voiced by patients?
fear and recurrence, chronic or acute pain, sexual problems, fatigue, guilt for delaying screening or treatment, behavior that may have increased the risk for cancer, changes in physical appearance, depression, sleep problems, change in role performance, being a financial burden of his or her loved ones.
Which medication can be given to reduce uric acid formation? When should it be started?
Allopurinol-initiated a few days before treatment and continued for 3-5 days after.
How long can bone marrow last once extracted? How is bone marrow infused?
3 years or more.
Through a central line WITHOUT a filter over 1-4 hours.
Why does cultural and religious influence play a role in pain management?
Some cultures tend to minimize pain and patients with those cultural backgrounds may be less likely to express pain.
Other cultures expect the expression of pain, and patients with those cultural backgrounds may exhibit a greater overt expression of pain.
Remain nonjudgmental
How often should patients be weighed? What percentage of weight loss indicates the patient is at risk for nutritional deficits?
Patients should be weighed daily. A 5% weight loss indicate the patient is at risk for developing malnutrition. Once a 10lb weight loss occurs it is difficult for the patient to maintain adequate nutritional status.
What factors may determine how a patient will cope with the diagnosis of cancer?
-ability to cope with stressful events in the past.
-availability of significant others
-Ability to express feelings and concerns
-Age at the time of diagnosis
-Extent of disease
-Disruption of body image
-Presence of symptoms
-experience with cancer
-Attitude associated with cancer
Which medication is given to make urine alkaline? What is the goal urine pH?
Sodium bicarbonate
goal urine pH is over 7
What are patient's at increased risk for when receiving a bone marrow transplant?
Infection and sepsis.
Which medications are sustained released that is effective in the management of terminally ill patients with pain?
MS Contin, Kadian, or morphine sulfate
How can a patient add nutrition to their foods?
Nutritional supplements can be added in place of milk when cooking or baking. They can also easily be added to scrambled eggs, pudding, custard, mashed potatoes, cereal, and cream sauces.
Packages of instant breakfast can be used as indicated or sprinkled on cereals, desserts, and casseroles.
What nursing intervention can a nurse do to exhibit caring?
Touch maybe more effective than words
What medication can be giving to lower potassium by binding it into the stool to be excreted?
sodium polystyrene (Kayexalate)
What interventions are done while a patient is receiving a bone marrow transplant to assess for infection?
-Prophylactic antibiotic and antiviral (usually acyclovir)
-Patients stay in special airflow units, and routine cultures of blood, urine, throat, and stool are completed.
If a patient is on a sustained-release pain medication but is experiencing breakthrough pain, what should the nurse do?
Administer PRN immediate release medications such as hydromorphone (Dilaudid), morphine, oxycodone, fentanyl, and methadone
Which medication can be prescribed to manage anorexia and stimulate appetite?
megestrol (Megace)
What is the primary focus of hospice?
Enhance the patient's quality of life not extending it.
What is important to place on your patients at risk for tumor lysis syndrome and electrolyte imbalances?
Cardiac monitoring
What does the survival rate after a bone marrow transplant depend on?
Patient's age, remission, and clinical status at the time of transplantation.
What are some nursing interventions that nurses can do without a physician order to help their patient's control their pain?
Aroma therapy, guided imagery, repositioning, massages, promote rest
What advice can the nurse give patient's with altered taste from chemotherapy?
Experiment with different seasonings to mask the altered taste. Lemon juice, onion, mint, basil, and fruit juice marinades may improve the taste of fish and certain meats. Bacon bits, onion, and pieces of ham may enhance the taste of vegetables.
Where are hospice services located?
Freestanding hospice centers, hospices within a hospital or skilled nursing facility, or at home arrangements.