Nur1212C Study Guide
Exam #3
Colon Cancer
Risk Factors: older than 50, genetic predisposition, family history, polyps, inflammatory bowel diseases (Crohn’s,
ulcerative colitis), long-term smoking, obesity, physical inactivity, heavy alcohol consumption, malnutrition (high
fat/low fiber)
Signs/Symptoms: blood in stool, change in bowel pattern, weight loss, anemia
Diagnostics: fecal occult blood test (3 separate stool samples over 3 days), Carcinoembryonic antigen (CEA), FIT
(annually), FIT0DNA (Cologuard), double-contrast barium enema, colonoscopy, CT, MRI, sigmoidoscopy;
Colonoscopy is the definitive test for the diagnosis of colorectal cancer.
Treatments: Radiation therapy, chemotherapy, surgery (colon resection, colectomy, colostomy)
Community Education
o Screening: occult blood testing (every 5 yrs), sigmoidoscopy (every 5 yrs), double-contrast barium enema
(every 5 years) or colonoscopy (every 10 yrs) for adults beginning at age 50 years until 75 years of age
o Nutrition: decrease fat, refined carbohydrates, and low-fiber foods, increase baked or broiled foods, high
fiber, low animal fat and brassica vegetables (broccoli, cabbage, cauliflower, and sprouts)
o Other: educate on hazards of smoking, excessive alcohol, and physical inactivity
Patient Education (treatments): colostomy care
Prostate Cancer
Risk Factors: male, older than 65, family history, African Americans, poor nutrition (high animal fat, red meat,
complex carbs and low-fiber), exposure to environmental toxins
Signs/Symptoms: difficulty in starting urination, frequent bladder infections, urinary retention, nocturia,
hematuria, pain in pelvis, spine, hips or ribs
Diagnostics: digital rectal examination (DRE), Prostate-specific antigen (PSA), transrectal ultrasound (TRUS) with
biopsy, lymph node biopsy, CT, MRI
Treatments: active surveillance (AS), Surgery is the most common intervention for a cure. Minimally invasive
surgery (laparoscopic radical prostatectomy), radical prostatectomy (prostate removal), bilateral orchiectomy
(removal of both testicles), radiation therapy, hormone therapy, and chemotherapy (less often)
Community Education
o Screening: prostate-specific antigen testing (40-65 yrs)
o Nutrition: decrease fat (red meat), increase fish, omega-3 fatty acids, fruits, vegetables, high fiber
Patient Education (treatments): draw PSA prior to DRE, PSA blood tests are taken 6 weeks after surgery and then
every 4 to 6 months to monitor progress.
Colostomy/Urinary Diversion Care
Teach patients and families or other caregivers about:
• How to handle, assemble, and apply all ostomy equipment
• The normal appearance of the stoma
• Signs and symptoms of complications
• Measurement of the stoma
• The choice, use, care, and application of the appropriate appliance to cover the stoma
• Measures to protect the skin adjacent to the stoma
• Nutrition changes to control gas and odor
• Resumption of normal activities, including work, travel, and sexual intercourse
, Seizures
Types:
o Generalized (tonic-clonic, tonic, clonic, myoclonic, atonic): involves both cerebral hemispheres
Tonic-clonic (2-5 min): aura, stiffening or rigidity of muscles (arms/legs in particular), immediate
loss of consciousness, followed by rhythmic jerking of all extremities, biting of tongue,
incontinence of urine or feces. Fatigue, acute confusion, and lethargy may last up to an hour
after the seizure.
Tonic (30 sec – several min): abrupt increase in muscle tone, loss of consciousness, and
autonomic changes
Clonic (several minutes): muscle contraction and relaxation
Myoclonic (few seconds): brief jerking or stiffening of the extremities that may occur singly or in
groups, fall risk
Atonic (seconds): sudden loss of muscle tone, usually resulting in a fall, followed by postictal
(after the seizure) confusion
o Partial (complex, simple): aka focal or local, begin in part of one cerebral hemisphere
Complex: loss of consciousness (1-3 min), unaware of environment, wandering, amnesia,
symptom, similar to dementia
Simple: maintains consciousness, aura (unusual sensation), one-sided movement of an
extremity, unusual sensations, autonomic symptoms
o Unclassified/Idiopathic: account for ½ of seizures, no known cause
Risk Factors/Causes: Primary or idiopathic epilepsy is not associated with any identifiable brain lesion or other
specific cause; however, genetic factors most likely play a role in its development. Secondary seizures result from
an underlying brain lesion, most commonly a tumor or trauma. They may also be caused by: Metabolic disorders,
Acute alcohol withdrawal, Electrolyte disturbances (e.g., hyperkalemia, water intoxication, hypoglycemia), High
fever, Stroke, Head injury, Substance abuse and Heart disease. Seizures resulting from these problems are not
considered epilepsy. Various risk factors can trigger a seizure, such as increased physical activity, emotional
stress, excessive fatigue, alcohol or caffeine consumption, or certain foods or chemicals.
Diagnostics: Diagnosis is based on the history and physical examination. A variety of diagnostic tests are
performed to rule out other causes of seizure activity and to confirm the diagnosis of epilepsy. Typical tests:
electroencephalogram (EEG), computed tomography (CT) scan, MRI, or positron emission tomography (PET)
scan. Laboratory studies are performed to identify metabolic or other disorders that may cause or contribute to
seizure activity.
Treatments: Removing or treating the underlying condition or cause of the seizure manages secondary epilepsy
and seizures that are not considered epileptic. In most cases, primary epilepsy is successfully managed through
drug therapy (antiepileptics). Patients who cannot be managed effectively with drug therapy may be candidates
for surgery, including vagal nerve stimulation (VNS) and conventional surgical procedures. VNS has been very
successful for many patients with epilepsy.
Precautions/Management: ensure oxygen and suctioning equipment with an airway are readily available, pad
siderails, lower bed, place mattress on floor, do not place anything in patient’s mouth, protect patient from
injury, turn patient on side, loosen restrictive clothing, maintain airway, suction secretions, do not restrain,
document seizure activity
Documentation: # of occurrences, date, time (start/stop), duration, location, type(s), sequence of progression,
LOC, eye changes, incontinence, aura present, drowsiness, weakness, recovery time, etc.
Patient/Family Education
o Drug Therapy: AEDs must not be stopped even if the seizures have stopped, drug info (actions, side
effects, missing dose), importance of blood draws
o Other: A balanced diet, proper rest, and stress-reduction techniques usually minimize the risk for
breakthrough seizures.
Seizure Complications: Status epilepticus is a medical emergency and is a prolonged seizure lasting longer than 5
minutes or repeated, rapid succession seizures/spasms without intervals of consciousness over the course of 30
minutes. It is a potential complication of all types of seizures. Seizures lasting longer than 10 minutes can cause
Exam #3
Colon Cancer
Risk Factors: older than 50, genetic predisposition, family history, polyps, inflammatory bowel diseases (Crohn’s,
ulcerative colitis), long-term smoking, obesity, physical inactivity, heavy alcohol consumption, malnutrition (high
fat/low fiber)
Signs/Symptoms: blood in stool, change in bowel pattern, weight loss, anemia
Diagnostics: fecal occult blood test (3 separate stool samples over 3 days), Carcinoembryonic antigen (CEA), FIT
(annually), FIT0DNA (Cologuard), double-contrast barium enema, colonoscopy, CT, MRI, sigmoidoscopy;
Colonoscopy is the definitive test for the diagnosis of colorectal cancer.
Treatments: Radiation therapy, chemotherapy, surgery (colon resection, colectomy, colostomy)
Community Education
o Screening: occult blood testing (every 5 yrs), sigmoidoscopy (every 5 yrs), double-contrast barium enema
(every 5 years) or colonoscopy (every 10 yrs) for adults beginning at age 50 years until 75 years of age
o Nutrition: decrease fat, refined carbohydrates, and low-fiber foods, increase baked or broiled foods, high
fiber, low animal fat and brassica vegetables (broccoli, cabbage, cauliflower, and sprouts)
o Other: educate on hazards of smoking, excessive alcohol, and physical inactivity
Patient Education (treatments): colostomy care
Prostate Cancer
Risk Factors: male, older than 65, family history, African Americans, poor nutrition (high animal fat, red meat,
complex carbs and low-fiber), exposure to environmental toxins
Signs/Symptoms: difficulty in starting urination, frequent bladder infections, urinary retention, nocturia,
hematuria, pain in pelvis, spine, hips or ribs
Diagnostics: digital rectal examination (DRE), Prostate-specific antigen (PSA), transrectal ultrasound (TRUS) with
biopsy, lymph node biopsy, CT, MRI
Treatments: active surveillance (AS), Surgery is the most common intervention for a cure. Minimally invasive
surgery (laparoscopic radical prostatectomy), radical prostatectomy (prostate removal), bilateral orchiectomy
(removal of both testicles), radiation therapy, hormone therapy, and chemotherapy (less often)
Community Education
o Screening: prostate-specific antigen testing (40-65 yrs)
o Nutrition: decrease fat (red meat), increase fish, omega-3 fatty acids, fruits, vegetables, high fiber
Patient Education (treatments): draw PSA prior to DRE, PSA blood tests are taken 6 weeks after surgery and then
every 4 to 6 months to monitor progress.
Colostomy/Urinary Diversion Care
Teach patients and families or other caregivers about:
• How to handle, assemble, and apply all ostomy equipment
• The normal appearance of the stoma
• Signs and symptoms of complications
• Measurement of the stoma
• The choice, use, care, and application of the appropriate appliance to cover the stoma
• Measures to protect the skin adjacent to the stoma
• Nutrition changes to control gas and odor
• Resumption of normal activities, including work, travel, and sexual intercourse
, Seizures
Types:
o Generalized (tonic-clonic, tonic, clonic, myoclonic, atonic): involves both cerebral hemispheres
Tonic-clonic (2-5 min): aura, stiffening or rigidity of muscles (arms/legs in particular), immediate
loss of consciousness, followed by rhythmic jerking of all extremities, biting of tongue,
incontinence of urine or feces. Fatigue, acute confusion, and lethargy may last up to an hour
after the seizure.
Tonic (30 sec – several min): abrupt increase in muscle tone, loss of consciousness, and
autonomic changes
Clonic (several minutes): muscle contraction and relaxation
Myoclonic (few seconds): brief jerking or stiffening of the extremities that may occur singly or in
groups, fall risk
Atonic (seconds): sudden loss of muscle tone, usually resulting in a fall, followed by postictal
(after the seizure) confusion
o Partial (complex, simple): aka focal or local, begin in part of one cerebral hemisphere
Complex: loss of consciousness (1-3 min), unaware of environment, wandering, amnesia,
symptom, similar to dementia
Simple: maintains consciousness, aura (unusual sensation), one-sided movement of an
extremity, unusual sensations, autonomic symptoms
o Unclassified/Idiopathic: account for ½ of seizures, no known cause
Risk Factors/Causes: Primary or idiopathic epilepsy is not associated with any identifiable brain lesion or other
specific cause; however, genetic factors most likely play a role in its development. Secondary seizures result from
an underlying brain lesion, most commonly a tumor or trauma. They may also be caused by: Metabolic disorders,
Acute alcohol withdrawal, Electrolyte disturbances (e.g., hyperkalemia, water intoxication, hypoglycemia), High
fever, Stroke, Head injury, Substance abuse and Heart disease. Seizures resulting from these problems are not
considered epilepsy. Various risk factors can trigger a seizure, such as increased physical activity, emotional
stress, excessive fatigue, alcohol or caffeine consumption, or certain foods or chemicals.
Diagnostics: Diagnosis is based on the history and physical examination. A variety of diagnostic tests are
performed to rule out other causes of seizure activity and to confirm the diagnosis of epilepsy. Typical tests:
electroencephalogram (EEG), computed tomography (CT) scan, MRI, or positron emission tomography (PET)
scan. Laboratory studies are performed to identify metabolic or other disorders that may cause or contribute to
seizure activity.
Treatments: Removing or treating the underlying condition or cause of the seizure manages secondary epilepsy
and seizures that are not considered epileptic. In most cases, primary epilepsy is successfully managed through
drug therapy (antiepileptics). Patients who cannot be managed effectively with drug therapy may be candidates
for surgery, including vagal nerve stimulation (VNS) and conventional surgical procedures. VNS has been very
successful for many patients with epilepsy.
Precautions/Management: ensure oxygen and suctioning equipment with an airway are readily available, pad
siderails, lower bed, place mattress on floor, do not place anything in patient’s mouth, protect patient from
injury, turn patient on side, loosen restrictive clothing, maintain airway, suction secretions, do not restrain,
document seizure activity
Documentation: # of occurrences, date, time (start/stop), duration, location, type(s), sequence of progression,
LOC, eye changes, incontinence, aura present, drowsiness, weakness, recovery time, etc.
Patient/Family Education
o Drug Therapy: AEDs must not be stopped even if the seizures have stopped, drug info (actions, side
effects, missing dose), importance of blood draws
o Other: A balanced diet, proper rest, and stress-reduction techniques usually minimize the risk for
breakthrough seizures.
Seizure Complications: Status epilepticus is a medical emergency and is a prolonged seizure lasting longer than 5
minutes or repeated, rapid succession seizures/spasms without intervals of consciousness over the course of 30
minutes. It is a potential complication of all types of seizures. Seizures lasting longer than 10 minutes can cause
