NSG233/ NSG 233 Exam 4 Review: (New
2024/ 2025 Update) Med Surg III | Questions
and Verified Answers| 100% Correct| A
Grade – Herzing
QUESTION
Colon Cancer Diagnostic
Answer:
Because colonoscopy is the only screening test that can also simultaneously remove
precancerous polyps, thus preventing colorectal cancer, other experts recommend 10-year
colonoscopies beginning at the age of 50 years as the major screening test for colorectal cancer.
QUESTION
Chemo/Capecitabine Adverse Effects
Answer:
The most common adverse effects of capecitabine include anemia, neutropenia, fatigue, diarrhea,
and palmar-plantar erythrodysesthesia (PPE; hand-foot syndrome), which manifests by
reddening, pain, and swelling of the palms of the hands and soles of the feet
QUESTION
Medications Pancreatic Cancer
Answer:
Although pancreatic tumors may be resistant to standard radiation therapy, the patient may be
treated with radiation and chemotherapy (5-fluorouracil [5-FU, Adrucil], leucovorin
[Wellcovorin], and gemcitabine [Gemzar]). Currently, gemcitabine is the standard of care for
patients with metastatic pancreatic cancer and has been found to lengthen survival.
The targeted anticancer drug erlotinib (Tarceva) has demonstrated a slight improvement in
advanced pancreatic cancer survival when used in combination with gemcitabine.
,QUESTION
Colon Cancer Metastasis
Answer:
When metastasis occurs, the liver is implicated half the time. Therapy targeted to treat metastases
to the liver can include surgical resection, radiofrequency ablation, and intra-arterial
chemotherapy
QUESTION
Surgical management of pancreatic cancer
Answer:
A pancreaticoduodenectomy (Whipple procedure or resection) is used for potentially resectable
cancer of the head of the pancreas. This procedure involves removal of the gallbladder, a portion
of the stomach, duodenum, proximal jejunum, head of the pancreas, and distal common bile
duct. Reconstruction involves anastomosis of the remaining pancreas and stomach to the
jejunum. If the tumor cannot be excised, the jaundice may be relieved by diverting the bile flow
into the jejunum by anastomosing the jejunum to the gallbladder, a procedure known as
cholecystojejunostomy.
QUESTION
Treating pancreatic cancer
Answer:
If the tumor is resectable and localized (typically tumors in the head of the pancreas), the
surgical procedure to remove it is usually extensive. However, total excision of the lesion often
is not possible for two reasons: (1) extensive growth of tumor before diagnosis and (2) probable
widespread metastases (especially to the liver, lungs, and bones). More often, treatment is
limited to palliative measures. Although pancreatic tumors may be resistant to standard radiation
therapy, the patient may be treated with radiation and chemotherapy
QUESTION
Interventions for gastric cancer
Answer:
, Reducing Anxiety: Good environment, education about treatment
Promoting Optimal Nutrition: The nurse encourages the patient to eat small, frequent portions of
nonirritating foods to decrease gastric irritation. Food supplements should be high in calories, as
well as vitamins A and C and iron, to enhance tissue repair. Because the patient may develop
dumping syndrome when enteral feeding resumes after gastric resection, the nurse explains ways
to prevent and manage it and informs the patient that symptoms often resolve after several
months. Management of dumping syndrome includes encouraging six small feedings daily that
are low in carbohydrates and sugar and the consumption of fluids between meals rather than with
meals.
Relieving Pain: The nurse administers analgesic agents as prescribed. A continuous IV infusion
of an opioid or a patient-controlled analgesia (PCA) pump set to infuse an opioid may be
necessary to mitigate postoperative pain. The nurse routinely assesses the frequency, intensity,
and duration of the pain to determine the effectiveness of the analgesic agent.
Proving Psychosocial Support
QUESTION
Assessing Gastric Cancer
Answer:
The physical examination is usually not helpful in detecting the cancer because most early
gastric tumors are not palpable. Advanced gastric cancer may be palpable as a mass. Ascites and
hepatomegaly (enlarged liver) may be apparent if the cancer cells have metastasized to the liver.
Palpable nodules around the umbilicus, called Sister Mary Joseph's nodules, are a sign of a GI
malignancy, usually a gastric cancer.
QUESTION
Chemo and targeted therapy to treat gastric cancer
Answer:
Chemo: Chemotherapy may also be used in addition to surgery as adjuvant treatment of gastric
cancer. Chemotherapeutic agents often include fluorouracil (5-FU), carboplatin (Paraplatin),
capecitabine (Xeloda), cisplatin (Platinol), docetaxel (Taxotere), epirubicin (Ellence), irinotecan
(campostar), oxaliplatin (Eloxatin), and paclitaxel (Taxol). For improved tumor response rates, it
is more common to administer combination chemotherapy, primarily 5-FU-based therapy, with
other agents (e.g., 5-FU plus cisplatin or oxaliplatin)
Target Therapies: Targeted therapies have become an important addition to the treatment of
advanced gastric cancers (NCCN, 2015). Trastuzumab (a recombinant humanized anti-HER-2
monoclonal antibody) prescribed in combination with fluorouracil or capecitabine and cisplatin
