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NUR 2900 Exam #1 Blueprint
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NUR 2900 Exam #1 Blueprint
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NUR 2900 Exam #1 Blueprint2 questions related to administration of chemotherapy - ANS-Have extravasation kit
readily available with emergency equipment and antidote meds
ALWAYS REMEMBER 5 RIGHTS OF MEDICATION ADMINISTRATION
Lab and physical assessments of metabolic indices and the dermatologic, hematologic,
hepatic, renal, cardiovascular, neurologic, and pulmonary systems are critical
Gloves & gown worn for administration
2 questions related to fatigue - ANS-Experience other symptoms concurrently → pain,
dyspnea, anemia, sleep disturbances, or depression
Distinguish between acute fatigue → after an energy-demanding experience (serves
protective function) and cancer-related fatigue → distressing, persistent, subjective
sense of physical, emotional and/or cognitive tiredness related to cancer or cancer
treatment
5FU (fluorouracil) - ANS-Antimetabolite agent that interferes with enzyme function or
DNA synthesis
Given IV or topical
Can cause anemia, thrombocytopenia, and leukopenia
May cause an itchy rash, and will make skin more susceptible to sun
S/S: Nausea, vomiting, diarrhea, bone marrow suppression, stomatitis.
Increased risk of infection and bleeding
For example, leucovorin (Wellcovorin) is often given with fluorouracil (5-FU) to treat
colorectal cancer. Leucovorin, a compound similar to folic acid, helps fluorouracil bind
with an enzyme inside of cancer cells and enhances the ability of fluorouracil to remain
in the intracellular environment. Leucovorin also rescues normal cells from the toxic
effects of high doses of methotrexate (Trexall). When given at certain doses for the
treatment of some forms of leukemia or lymphoma, methotrexate causes a folic acid
deficiency in cells, resulting in cell death. Significant toxicity, including severe bone
marrow suppression, mucositis, diarrhea and liver, and lung and kidney damage, can
occur. Leucovorin helps to prevent or lessen these toxicities.
Administration of packed cells - ANS-If patient has any kind of reaction to blood = STOP
infusion immediately
Need TWO RNs to check the blood is right for patient
Check if patient's blood has been typed and crossmatched (Priority: ABO Compatibility)
Take patients vital signs as a baseline for comparison
Has to be administered within 30 min of removal from fridge, and infused over 4 hours
, First 15 min, transfuse slowly (to look for reaction - Critical time)
Monitor closely for 15-30 min to detect signs (nurse must stay with patient)
Be alert for signs of adverse reactions (Circulatory overload, sepsis, febrile reaction,
allergic reaction, acute hemolytic reaction).
After administration, check Vital signs and breath sounds to compare with baseline
measurements
Hgb goes up 1 or 2 with every pack
B12 deficiency → diagnosis question, who is at risk? - ANS-Vit B12 deficiency anemia
occurs when an individual does not take enough foods that contain B12. People on
vegetarian diets or not taking in enough dairy products are at risk to develop it.
RBC studies, cells would show up macrocytic (anemic)
the intrinsic factor is normally secreted by cells within the gastric mucosa; binds with
B12 and travels with it to the ileum, where it is absorbed. Without intrinsic factor, orally
consumed B12 cannot be adequately absorbed and erythrocyte production is eventually
diminished
Concepts related to cancer → basic understanding - ANS-Pathophysiology:
uncontrolled cell growth
Development 3 Stages: Initiation, Promotion, Progression
Risk Factors: Genetics, age, environmental carcinogens, chemical carcinogens,
exposure to virus, poverty, stress, diet, occupation, alcohol, drug use, sun exposure.
Treatment Factors: Tumor type, extent of disease, patient physical status.
Treatment types: Surgery, Chemotherapy, Radiation
First choice: Surgery
Chemotherapy works by target different stages of cell cycle
Radiation Therapy: two types, external and internal
Diagnostic study for Hodgkin's Disease - ANS-Lymph node biopsy. The entire node is
removed and checked for the Reed-Sternberg cells and staged (I-IV).
Lymph Nodes are enlarged.
DIC → risk factors - ANS-Patho: Altered hemostatic mechanisms (clotting & bleeding)
from underlying issue
Risk factors - cancer, blood transfusions, tissue injury, sepsis, surgery
History - of abnormal bleeding without a history of serious hemorrhagic disorder,
petechiae, bruising, severe muscle/back/abdominal pain.
Physical findings - GI bleed/hematuria, signs of thrombosis, jaundice, hypotension,
tachycardia, hemoptysis, epistaxis, oliguria, dyspnea/tachypnea, pleural friction rub,
confusion
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