Misc.
Labs
Radiation
Chemo
Pharmacology
100
What are common postoperative complications patients with CA are at risk for?
Infection
Impaired wound healing
Altered pulmonary or renal function
VTE
Difficulty adjusting to body disfigurement
100
When does nadir usually occur?
7-10 days after treatment
100
Radiation is most effective on replicating cells - which areas are most affected?
Bone marrow, GI tract, hair follicles
100
What PPE may be required when administering chemotherapy?
Gloves, mask, goggles, gown
100
Identify common side effects of opioids.
N/V, constipation, CNS depression, urinary retention, diaphoresis and flushing, pupil constriction, itching
200
Describe the characteristics of the following tumor staging:
T4N1M0
Large tumor, abnormal lymph nodes, no mets
200
Identify risk factors for neutropenia.
The lower the ANC
The longer the ANC is low
Corticosteroid therapy (prednisone)
Hematologic malignancies
Loss of protective barriers
200
What 2 categories of visitors should avoid visiting a client undergoing internal radiation?
Children and pregnant women
200
Many chemotherapy drugs are classified as ________. If they infiltrate into the tissue, it is called _________.
Vesicants
Extravasation
200
Cisplatin is an alkylating agent used to treat bladder cancer. Identify common side effects from this antineoplastic medication.
Renal failure
Myelosuppression
N/V
Stomatitis
Alopecia
300
Identify whether each of the following characteristics define benign or malignant cells:
Localized effects
Poorly differentiated
Invade surrounding tissue
Benign
Malignant
Malignant
300
Identify the normal lab values for WBC, Hgb, and platelets.
WBC 4,000-10,500
Hgb 12-18
Platelets 150,000-400,000
300
What 3 principles should staff follow to protect themselves from radiation from a patient receiving internal radiation?
Time
Distance
Shielding
300
Dosage for chemo is based on what calculation?
**Double points if you know the actual formula.
Body Surface Area (BSA)
300
When should filgrastim (Neupogen) be given in relation to chemo?
At least 24 hours after treatment
400
Identify 4 warning signs of CA
Change in bowel/bladder habits
A sore that doesn't heal
Unusual bleeding or discharge
Thickening or lump
Indigestion or difficulty swallowing
Obvious change in mole
Nagging cough
400
What precautions should be put in place when a client's platelet count is < 100,000? Describe what these precautions are.
Bleeding precautions: avoid falls, contact sports, use stool softeners, avoid suppositories/enemas/rectal temps, use soft toothbrush, avoid flossing, avoid straight-edge razor, avoid anticoagulants or NSAIDs, use lubricant with sexual intercourse, OCP, blow nose gently, lubricate lips.
400
Describe common side effects associated with external radiation.
Alopecia, erythema, desquamation, ulceration, stomatitis, dry mouth, mucositis, N/V/D, leukopenia, **symptoms usually localized to area of radiation
400
If you suspect extravasation during a chemotherapy infusion, what should you do?
Stop the infusion, contact the provider, do not take out the IV.
May be able to administer an antidote.
400
For opioids, define the ceiling effect, tolerance, physical dependence, and psychological dependence.
Ceiling effect - drug reaches a maximum analgesic effect despite higher doses
Tolerance - larger doses required to maintain same level of pain control
Physical dependence - adaptation of the body to the presence of an opioid
Psychological dependence - pattern of compulsive drug use characterized by intense cravings
500
Identify 5 patient education recommendations to prevent CA.
Avoid sun 11a-3p
Stop smoking
Limit alcohol
Diet rich in whole grains, fatty fish, fruits/vegs, limit red/processed meats
Maintain weight
500
Identify at least 5 components of neutropenic precautions.
Private room, limit visitors, no sick visitors, no visits with recent live vaccines, avoid raw or uncooked foods, avoid fresh fruits or vegs, avoid fresh flowers and plants, strict handwashing, no buffets, bottled water is safe, gloves/gowns/masks may be worn
500
Identify 5 patient education recommendations to prevent radiation-associated skin breakdown.
Avoid perfumes or lotions
Lukewarm water and mild soaps to bathe
Avoid rubbing or scratching
No straight-edge razor
No heat or ice
No direct sun or cold weather
Avoid tight clothing
Manage pruritus
500
What lab values should the nurse review immediately before administering chemotherapy?
What condition is most often the cause of holding chemotherapy?
CBC - WBC, RBC, Platelets
Neutropenia
500
Your patient is ordered morphine 4mg/hr. The available concentration is 1000mg in 500mL. At what rate will you set the pump in mL/hr to administer the desired dose?
2 mL/hr