Infection
Name two common super-infections that happen when normal flora is destroyed
Yeast (candida albicans) and C.Diff
TNM Staging System
T—primary tumor
N—regional nodes
M—metastasis
Treatment of
Immune Deficiencies
Immune globulin (Ig)
Bone marrow transplant
Granulocyte colony-stimulating factor (filgrastim [Neupogen])
Antimicrobial agents
OSA symptoms, complications, treatment:
sx: snoring, daytime sleepiness
complications: untreated can lead to MI, stroke, fatigue, death
tx:sleep study and CPAP
Diagnosis and tx for this patient:
Tachycardic, distracted, 5lb weight loss in 2 weeks
Hyperthyroidism
Methimazole (Tapazole), radioactive iodine, beta-blockers, mild sedatives
Inflammation:
Symptoms of a localized reaction
Symptoms of a systemic reaction
redness, heat, swelling, and pain
headache, myalgia, fever, diaphoresis, chills, anorexia, and malaise
Side Effects of Chemotherapy
Severe anemia
Reduced immunity
Thrombocytopenia (decreased platelets)
Alopecia (hair loss)
Mucositis (sores in the mouth)
Nausea and vomiting
Constipation or diarrhea
Non-Hodgkin’s Lymphoma (NHL): Who and where
Seventh most common cancer in men and women
Incidence is higher in men than women
Less predictable and tends to spread to other body sites much more rapidly than HL.
NHL tumors can occur in the brain, respiratory system, spleen, GI tract, bone, or other parts of the body.
Epistaxis Management:
Management
Sit forward and apply direct pressure by pinching the nose just below the bone
Cold compresses
May require cauterization, packing or small balloon to stop the bleeding.
Diagnose this pt: pregnant, enlarged chin, feet and fingers
Acromegaly
The infectious triad
the host, the agent, and the environment
what are two things to be mindful of when caring for cancer patients? (think precautions)
chemo is a vesicant (watch skin and IV)
use chemo precautions when handling body fluids
Explain primary lymphedema vs secondary
congenital: females-teens 20s
surgery usually mastectomy
NO BPs that side, elevate
Purpose of tracheostomy
To assist or control ventilation by mechanical means over a prolonged period of time
To facilitate suctioning of secretions in the air passages of patients unable to cough
To prevent aspiration of oral and gastric secretions (as in unconscious or paralyzed patients)
To bypass a constricted or obstructed upper airway
Diagnose and treat this patient:
Sx: fatigue, nocturia
PMH: TBI
Diabetes Insipidus
Tx: Replacement of fluid and electrolytes
Hormone therapy
Early detection, maintenance of fluid and electrolyte balance, and patient education
Baseline vital signs and weight are to accurately document and monitor throughout therapy.
Strict (hourly) intake and output monitoring are essential
Transmission-Based Precautions
Airborne infection isolation
Contact isolation
Droplet isolation
What causes fatigue with cancer patients.
Radiation fatigue-radiation requires an increased amount of energy to repair cells and tissues damaged by radiation
Meds
Side effects like N/V/D
Varicella zoster virus-What is it? Symptoms?
shingles:itching, burning, tingling, low-grade fever, rash
Caution with aspirin?
Aspirin should not be given to children younger than 18 years of age because aspirin has an association with Reye’s syndrome: serious condition causing confusion, brain swelling, liver damage
Diagnose and treatment for this patient:
Sx:weight gain with edema, muscle cramps
SIADH
Correct the underlying cause.
Restrict fluids to 500 to 1000 mL/day.
Administer sodium chloride, diuretics, and demeclocycline.
Symptoms of SIRS or sepsis:
Bonus: organisms that cause tSepsis
tachycardia (heart rate >90 beats/min), increased cardiac output, tachypnea (rapid breathing), fever (core temperature 100.4° F [38° C]), and an elevated WBC count. An altered level of consciousness may also occur.
Sepsis is most commonly associated with bacterial invasion from gram-negative bacteria such as Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae or gram-positive bacteria such as Staphylococcus aureus and Streptococcus pneumoniae
Kübler-Ross’ stages of dying
Denial (This can’t happen to me!)
Anger (Why me?)
Bargaining (Yes me, but…)
Depression (It is me. I give up…)
Acceptance (I’m ready…)
SLE symptoms
Painful or swollen joints and muscle pain
Extreme fatigue
Unexplained fever
Red rash usually on the face (malar rash or butterfly rash)
Loss of hair
Sensitivity to the sun
Weakness and profound fatigue
Mouth ulcers, poor appetite, weight loss,
Abnormal menses
Edema and swollen glands
Sinusitis Tx
Hot, moist packs over the sinus area can be helpful.
Inhaling moist steam thins secretions and helps to promote drainage.
Medications to promote vasoconstriction, reduce swelling, and promote drainage.
Decongestants
Infection may be treated with an antibiotic or anti-infective agent, often for at least 10 days.
Diagnose and treat this patient
Sx:tingling, numbness, irritability, tetany
Hypoparathyroidism
Acute:
IV calcium gluconate and Vitamin D
Oral or parenteral calcium salts
Chronic:
Parathormone replacement therapy, Vitamin D, and oral administration of calcium salts.
Nursing care revolves around electrolyte replacement and patient teaching.