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NUR 275 EXAM 3 WITH QUESTIONS AND CORRECT ANSWERS
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NUR 275 EXAM 3 WITH QUESTIONS AND CORRECT ANSWERS...
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NUR 275 EXAM 3 WITH QUESTIONS ANDCORRECT ANSWERS
What is extravasation (infiltration)? - ANSWER drug leakage into surrounding
tissue
How should causative IV solutions be given - ANSWER Through a central line
Nursing interventions for infiltration - ANSWER § Stop infusion immediately and
notify the provider
§ Check IV site frequently
§ Assess for pain, burning, and skin
§ Neurovascular assessment
§ Warm compress= alkaloids; cold compress= alkylating/antibiotics
Why do we use caution in giving drugs such as Epoetin and Darbepoetin in these
patient - ANSWER There is an increase for bleeding and adverse effects along we
can drastically drop their platelet, RBC, HGB, HCT counts. This calls for us to give
Epoetin when patients numbers are at least 10
Neutropenia - ANSWER low neutrophil count which causes increased risk for
infection
Neutropenic fevers - ANSWER anything above 100.4 is as immediate concern
Filgrastim (Neupogen)
§ Pegfilgrastim (Neulasta) - ANSWER Both help to make more WBC
Thrombocytopenia - ANSWER Decrease in circulating platelets.. imposes high risk
for excessive bleeding, from bone marrow suppression
Thrombocytopenia nursing main concern - ANSWER bleeding risk
<50,000 bleeding risk - ANSWER Caution.. use teaching these patients are high
risk for bleeding
,<20,000 bleeding risk - ANSWER Spontaneous bleeding risk
Education for thrombocytopenia - ANSWER Gentle handling of the patient
NO IM or venipuncture
Good oral hygiene (soft bristle tooth brush)
DO NOT administer enemas
Use electric razors
Antiemetics - ANSWER able to help well control the nausea/vomiting from chemo
In patients who have chemo induced nausea/vomiting what should be the nurses
main concern - ANSWER Fluid volume deficit/electrolyte imbalances
goal of antiemetics - ANSWER stay ahead, give before chemo
prolonged dehydration can cause - ANSWER renal failure
In patients who have chemo induced nausea/vomiting how do we treat fluid volume
deficit and electrolyte imbalances - ANSWER Isotonic fluids (LR's or NS 0.9%)
Mucositis - ANSWER sores in the mucous membranes
teaching points for mucositis - ANSWER Frequent oral assessments
Good oral hygiene
Soft bristled tooth brush
Gentle flossing once a day
(water pick preferred)
Saline rinses every hour while awake
Avoid mouthwashes that contain alcohol or drying agents
Myelosuppression - ANSWER bone marrow suppression
Why is myelosuppression a problem when considered mucositis - ANSWER Leads
to risk for systemic infection, BLEEDING RISK, and trauma risk
,is alopecia temporary - ANSWER yes
If a patient asks can you prevent alopecia how should you respond? If there are
interventions what can be done - ANSWER We can NOT prevent this from
happening
If getting chemotherapy we can provide cool caps as a way to limit the hair loss
**ONLY with chemotherapy can not do this with radiation*
Ways to support patients going through or will go through alopecia - ANSWER
Allow patient to decide if wanting to cut or shave head before
caps or hats
wigs
chemo brain - ANSWER reduced ability to concentrate, memory loss, or difficulty
learning
does chemo brain normally reverse? - ANSWER yes
chemo brain is most common in what cancer - ANSWER Most common in breast
cancer
Number one nursing consideration for chemo brain - ANSWER Help identify ways
to cope with this
Why is ovarian cancer such a late term diagnosed cancer - ANSWER Patients are
normally asymptomatic until later stages not noticing minor changes and think the
signs/symptoms mimic normal menopause symptoms
ANC Formula - ANSWER ANC = WBC x (% Neutrophils/100 + % Bands/100)
ANC values Not significant - ANSWER 1500-2000
ANC values Minimal significant - ANSWER 1000-1500
ANC values Moderate - ANSWER 500-1000
ANC values Severe - ANSWER <500 (isolation!!)
, Grading Cellular Differentiation - ANSWER Gx: Grade cannot be assessed
G1: Well differentiated (low grade)..looks like parent cell
G2: Moderately differentiated (intermediate grade)
G3: Poorly differentiated (high grade)
G4: Undifferentiated (high grade)
Tumor markers - ANSWER substances that produced by the cancer or by other
cells of the body in response to cancer or certain benign conditions
Tumor markers found - ANSWER blood, urine, stool, tumor tissues, or other
bodily fluids
Is there a "universal" tumor marker - ANSWER no
What 3 interacting factors influence cancer development - ANSWER Carcinogen
exposure, genetic predisposition, immune function
oma - ANSWER benign
sarcoma - ANSWER malignant
Secondary Prevention - ANSWER (Early detection)
o Routine screening
o Mammography & clinical breast exam (NOT self-breast exams)
o Prostate specific antigen (PSA) and digital rectal exam
o Colonoscopy
o Fecal occult blood
Primary Prevention - ANSWER Risk reduction
o Avoid carcinogens
o Modify risk factors
o Remove "at risk" tissues
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