Show:
External Radiation
Unsealed Internal Radiation
Sealed Internal Radiation
Chemotherapy
Oncological Emergencies
100
Another name for external radiation
What is Teletherapy?
100
Another name for internal (sealed and unsealed) radiation therapy.
What is brachytherapy?
100
These are the precautions the nurse must make when caring for a client with sealed radiation implants.
What are placing the client in a private room with radioactive material sign on the door, place portable lead shield in front of door, keep the door closed, wear dosimeter & lead apron facing the source of radiation at all times
100
These are the cells that chemotherapy affects.
What are neoplastic cells, hair, GI tract and bone marrow.
100
This condition consists of clotting then bleeding and is usually d/t sepsis or cancer. Monitor for clots & frank bleeding or oozing. Tx the cause, administer heparin and blood products. Place client on bleeding precautions.
What is Disseminated Intravascular Coagulation (DIC)?
200
The side effects of Teletherapy (External Radiation)
What are nausea, vomiting, diarrhea, bone marrow depression (myelosuppression), permanent skin changes & hair loss at the site, tissue fibrosis, altered taste, crippling fatigue & infertility?
200
These are the most important things to consider when dealing with radiation.
What is time, distance and shielding. Remember, never turn your unprotected back on any radiation source!
200
These are the restrictions regarding visitors.
What is no pregnant women or anyone under 16 y/o/a. Others can visit up to 30 minutes and they must keep 6 feet away from the client at all times
200
The complications of this side effect are fatigue, shortness of breath, bruising and bleeding, and infection.
What are myelosuppression (bone marrow suppression)?
200
This condition is due to too much antidiuretic hormone causing fluid overload (FVE) and loss of potassium. It can be due either to tumors or some chemo agents. S/S are of fluid overload (decreased sodium, weight gain, edema, JVD, crackles. Tx with fluid restriction. If severe: 3% sodium, lasix, and administer drugs that will block the kidney's response to ADH (ie. lithium, dilantin, florinef)
What is the Syndrome of Inappropriate ADH (SIADH)?
300
These are the instructions clients are given regarding the care of their skin.
What is "Do not wash off the markings, inspect the skin daily, keep the skin dry, wash radiation site with water only and other parts with mild soap & water, pat dry with soft towel, report areas of breakdown and dress with non-adherent dressings and paper tape, wear soft, loose clothing (natural fibers). No belts, bulkes, straps or anything that binds or rubs the skin over the radiated site.
300
These are the ways in which unsealed radiation is administered and why there are systemic effects resulting in radioactive body fluids.
What is oral, IV or intracavity instillation of radioactive substances used in the treatment of cancer?
300
This information is given to the client regarding the care they will receive while radioactive.
What is nursing time & care, visitors will be limited due to the risk of radiation exposure. Report dislodging or complications to staff immediately. Client is on bed-rest, flat in bed except for meals when they will be turned on their side. Implant will remain in from 48-144 hours. Linens & dressings will remain in the room until the source of radiation has been accounted for After the implant is removed, they will be bathed, (Douche if applicable) and the catheter will be removed
300
These are the precautions taken when administering chemotherapy.
What are chemo certification, protective gear (double chemo gloves, breathable gown, googles & mask, use of a biologic safety cabinet to prepare, wear surgical gloves for handling excretia, flush toliet twice after use, no sharing of bathroom, do not spray medication into the atmosphere when removing bubbles, wash skin under running water if it becomes contaminated, notify safety officer is there is a chemo spill and assure the IV does not extravasate.
300

 condition is due to bone metastasis with symptoms of somnolence, confusion, weakness, nausea, constipation and polyuria. It is treated with loop diuretics, IVF at 250-300 mL's/hr, chemotherapy, meds and diet to restrict this electrolyte.

What is hypercalcemia?

400
These are things that are contraindicated for the radiated site.
What are talcum powders, lotions, aloe with alcohol, sunscreen or straight razors?
400
These are the precautions that are taken in the care of the client with unsealed radiation.
What is isolation, tagging the room with a radioactive symbol, private bathroom, rotating personnel to avoid overexposure, no visitors x 48 hours (usually), collecting all paper plates, eating utensils, dressings, linens in impermeable bags and disposing of them by policy and procedure, collecting body fluids or any linens soiled with blue or purple linens/gowns in a shielded (lead) container
400
These are the interventions that are given prior to implantation.
What are douche, MOM, dulcolax suppository, enema, perineal preparation, and foley insertion.
400
These are the actions to take if a a client receiving a chemotherapeutic agent has complaints of burning, pain or there is redness, swelling or absence of blood return all clinical manifestations of extravasation.
What is Stop the infusion, aspirate back as much of the medication as possible, apply ice pack (unless it is vinca alkaloid) Inject one of teh following neutralizing agents (Nathiosulfate, hyaluronidase or sodium bicarbonate), monitor, call MD, complete incident report and recommend right atrial catheter (CVC)
400
This condition can result from tumors, enlarged lymph nodes, DIC or a clotted CVC. the s/s include swelling of the head, neck, headache, visual disturbances, neurological changes and loss of airway can occur. It is treated with removal of CVC line if cause, radiation & chemo if d/t cancer, airway, O2, steroids, diuretics & anticoagulants
What is Superior Vena Cava Syndrome?
500
These are the instructions the client is given about the their environment and diet.
What is avoiding direct skin exposure for 1 year after treatment, avoiding temperature extremes, alcohol-based mouthwashes, crowds, anyone with an infection. What is eating 2-3 hours before or after treadment to decrease nausea, eat small-frequent low residue meals, pace activities, have someone drive you to and from treatments, and use birth control
500
The nurse wears this to indicate how much radiation exposure they have developed.
What is a dosimeter?
500
These are the actions the nurse takes if the client's vaginal applicator (for example) becomes dislodged and falls out.
What is Never touching it with your hands, use a forcep and place in the lead, radioactive materials container, notify the radiation officer and physician immediately.
500
These are the treatments for the side effects of chemotherapy such as nausea & vomiting, diarrhea, stomatitis, skin care, alopecia, bone marrow suppression.
What are: For nausea & vomiting: premedicate with an antihistamine, antiemetic and IV hydration. NPO 4-6 hrs before chemo, small, frequent, well balanced meals high in calories, K, Ca, iron and protein. provide frequent mouth care, avoid food odors when cooking, keep environment clean, consider TPN or tube feeds. Diarrhea: clear liquids and progress to low residue diet. Increase potassium and fluids. Avoid hot or cold foods, protect rectal skin area with A & D ointment, give lomotil, kaopepctate, immodium (antidiarrheals), moniter fluid & electrolyte imbalances Stomatitis: soft tooth brushes, mouth care q 2-4 hours, viscousl lidocaine, salt & soda rinses, avoid alcohol based mouth wash, eat soft, bland foods at room temp, popsicles, remove dentures if sores are present, moisten lips with petroleum jelly Alopecia: Cut hair, wigs, turbans, scarves. Protect the scalp from sunshine, gentle combing or brushing, gentle shampoos, tourniquet around forehead for 20 minutes before and after chemo. Mylosuppression: Monitor Nadir, WBC, RBC/Hct/hgb & plts. Administer neupogen for decreased neutrophils and epogen (procrit, erythropoietin) for decreased RBC/Hct/Hgb. Neutropenic & bleeding precautions (review)
500
This condition results from a large number of tumor cells rupturing from chemotherapy or radiation, and they release their cell contents, causing hyperkalemia and high uric acid levels (total body gout). THe signs are arrhythmias, severe pain, hematuria and it can cause death if severe/untreated. Tx: IVF and sodium bicarbonate, dialysis, calcium chloride/gluconate, insulin & dextrose, kayexalate and allopurinal.
What is Tumor Lysis Syndrome