NUR 3112 final- blueprint Questions With Complete
Solutions
thrombocytopenia
monitor for petechiae, ecchymosis, bleeding from gumbs,
nosebleeds, blood in stools/urine/vomit
monitor platelet count
administer thrombopoietic medications such as oprelvekin
administer platelets as needed
no antiplatelet or anticoagulant meds (aspirin, enoxaparin)
avoid IVs and injections
apply pressure 10 min after obtaining blood
pt needs to call for assistance when leaving bed
bleeding precautions
oncological complication - hypercalcemia
- metastases to bone from lung, breast, colon, or ovarian cancer
- s/sx: depression, fatigue, n/v, polyuria, nocturia, confusion,
decreased LOC, dysrhythmias, shortened qt interval
- medications: loop diuretics, calcitonin, bisphosphonates,
normal saline
oncological complication - tumor lysis syndrome
due to large or rapidly growing cancers where cell contents are
rapidly released into blood stream after chemo or radiation.
- s/sx: hyperuricemia, hyperphosphatenia, hyperkalemia,
hypocalcemua
,- meds: allopurinol, loop diuretics, possible hemodialysis,
normal saline.
oncological complication - SVC syndrome
- svc obstruction -> engorgement of head and upper body
vessels
- s/sx: facial, periorbital edema, vein distention in head, neck ,
chest, erythema of upper body, epistaxis, headache, altered
LOC, seizures, dyspnea, cough, hoarseness, stridor.
oncological complication - spinal cord compression
neurological emergency, tumor in epidural space from cancers
of breast, lung, prostate, lymphomas
external radiation
tx: delivered to definined tissue volume
admin: fractioned doses
complications: fatigue and skin changes
nursing interventions: interdisciplinary collab, educate pt on tx
process, goals and side effects, emotional support, remind pt to
conserve energy
patient edu: skin reactions, avoid sun exposure, extreme temps,
keep affected area clean and dry and avoid tight fitting or wool
clothing over area, nothing topical, no swimmin pools, electric
razor in affected area
dry desquamation: lotion and tepid water
wet desquamation: rinse with normal saline, pat gently, observe
for infection or bleeding
, internal radiation
Radiation from inside out (brachytherapy)
ALARA
no visitors under 18 or pregnant or anyone longer than 30 min.
DIC
- sign of an underlying condition
- petechiae, tachycardia, tachypnea, hematemesis, hematuria
- profuse bleeding due to impairment of natural anticoagulant
pathways, mini clots are formed throuhgout body and no
platelets are available to stop bleeding elsewhere
DIC tx
blood products, anticoagulants (heparin) to inhibit microthrombi
formation and help organ perfusion, oxygen, fluid replacement,
correct electrolyte imbalances, vasopressor administration
parkinsons
- neurological development disorder that affects muscle
movement, leads to disability, caused by a loss of dopamine
- diagnostics: patient history and 2 cardinal manifestations
(TRAPS)
- CM: loss of dopamine, tremors, rigidity, akinesia, postural
instability
- tx: carbidopallevodopa - exogenous form of opamine
emergent treatment for a spinal cord injury
ABCD, stabilize, imaging, steroid administration
Solutions
thrombocytopenia
monitor for petechiae, ecchymosis, bleeding from gumbs,
nosebleeds, blood in stools/urine/vomit
monitor platelet count
administer thrombopoietic medications such as oprelvekin
administer platelets as needed
no antiplatelet or anticoagulant meds (aspirin, enoxaparin)
avoid IVs and injections
apply pressure 10 min after obtaining blood
pt needs to call for assistance when leaving bed
bleeding precautions
oncological complication - hypercalcemia
- metastases to bone from lung, breast, colon, or ovarian cancer
- s/sx: depression, fatigue, n/v, polyuria, nocturia, confusion,
decreased LOC, dysrhythmias, shortened qt interval
- medications: loop diuretics, calcitonin, bisphosphonates,
normal saline
oncological complication - tumor lysis syndrome
due to large or rapidly growing cancers where cell contents are
rapidly released into blood stream after chemo or radiation.
- s/sx: hyperuricemia, hyperphosphatenia, hyperkalemia,
hypocalcemua
,- meds: allopurinol, loop diuretics, possible hemodialysis,
normal saline.
oncological complication - SVC syndrome
- svc obstruction -> engorgement of head and upper body
vessels
- s/sx: facial, periorbital edema, vein distention in head, neck ,
chest, erythema of upper body, epistaxis, headache, altered
LOC, seizures, dyspnea, cough, hoarseness, stridor.
oncological complication - spinal cord compression
neurological emergency, tumor in epidural space from cancers
of breast, lung, prostate, lymphomas
external radiation
tx: delivered to definined tissue volume
admin: fractioned doses
complications: fatigue and skin changes
nursing interventions: interdisciplinary collab, educate pt on tx
process, goals and side effects, emotional support, remind pt to
conserve energy
patient edu: skin reactions, avoid sun exposure, extreme temps,
keep affected area clean and dry and avoid tight fitting or wool
clothing over area, nothing topical, no swimmin pools, electric
razor in affected area
dry desquamation: lotion and tepid water
wet desquamation: rinse with normal saline, pat gently, observe
for infection or bleeding
, internal radiation
Radiation from inside out (brachytherapy)
ALARA
no visitors under 18 or pregnant or anyone longer than 30 min.
DIC
- sign of an underlying condition
- petechiae, tachycardia, tachypnea, hematemesis, hematuria
- profuse bleeding due to impairment of natural anticoagulant
pathways, mini clots are formed throuhgout body and no
platelets are available to stop bleeding elsewhere
DIC tx
blood products, anticoagulants (heparin) to inhibit microthrombi
formation and help organ perfusion, oxygen, fluid replacement,
correct electrolyte imbalances, vasopressor administration
parkinsons
- neurological development disorder that affects muscle
movement, leads to disability, caused by a loss of dopamine
- diagnostics: patient history and 2 cardinal manifestations
(TRAPS)
- CM: loss of dopamine, tremors, rigidity, akinesia, postural
instability
- tx: carbidopallevodopa - exogenous form of opamine
emergent treatment for a spinal cord injury
ABCD, stabilize, imaging, steroid administration
