OCN Study Guide Questions with Complete
Solutions
How does Heparin help DIC? Interferes with thrombin production. Maintain PTT at 1-2
times the normal level (18-28 seconds)
S/S of septic shock Fever
Tachycardia
Hypotension
Most common cause of sepsis Gram (-) bacteria
Granulocytopenia failure of the bone marrow to make enough
white blood cells (neutrophils)
Highest risk factor for sepsis Prolonged granulocytopenia (less than 500/mm3)
What cancer commonly produces TLS? High grade lymphoma
,Define Tumor Lysis Syndrome (TLS) metabolic imbalance that occurs with rapid tumor
kill
Lab results indicating DIC Increased D Dimer
Increased FDP
Decreased fibrinogen
Decreased platelets
Lab results indicitave of TLS Hyperkalemia (>5.0)
Hyperphosphatemia (>4.5)
Hyperuricemia (>8.0)
Hypocalcemia (>10.5)
Increased BUN (>20)
Increased creatinine (>1.2)
Increased LDH (>333)
Lab tests done to monitor TLS K
,Phos
Uric Acid
Calcium
LDH
Renal function (BUN, Creatinine)
How to treat severe hyperkalemia hypertonic glucose and insulin. Shifts extracellular K
back into intracellular stores
How does Allopurinol work? decreases uric acid production and decreases uric acid
deposits in kidney
How does Rasburicase work? catalyses the conversion of uric acid to allantoin
S/S of hyperkalemia muscle weakness
muscle cramps
bradycardia
tall T waves
, S/S of hypokalemia decreased reflexes
irregular pulse
fatigue
N/V
flat t wave
V fib if severe
Calcium normal range 8.5-10.5 meq/L
S/S of hypercalcemia fatigue
lethargy
muscle weakness
impaired concentration
confusion
constipation
polyuria/polydipsia
Solutions
How does Heparin help DIC? Interferes with thrombin production. Maintain PTT at 1-2
times the normal level (18-28 seconds)
S/S of septic shock Fever
Tachycardia
Hypotension
Most common cause of sepsis Gram (-) bacteria
Granulocytopenia failure of the bone marrow to make enough
white blood cells (neutrophils)
Highest risk factor for sepsis Prolonged granulocytopenia (less than 500/mm3)
What cancer commonly produces TLS? High grade lymphoma
,Define Tumor Lysis Syndrome (TLS) metabolic imbalance that occurs with rapid tumor
kill
Lab results indicating DIC Increased D Dimer
Increased FDP
Decreased fibrinogen
Decreased platelets
Lab results indicitave of TLS Hyperkalemia (>5.0)
Hyperphosphatemia (>4.5)
Hyperuricemia (>8.0)
Hypocalcemia (>10.5)
Increased BUN (>20)
Increased creatinine (>1.2)
Increased LDH (>333)
Lab tests done to monitor TLS K
,Phos
Uric Acid
Calcium
LDH
Renal function (BUN, Creatinine)
How to treat severe hyperkalemia hypertonic glucose and insulin. Shifts extracellular K
back into intracellular stores
How does Allopurinol work? decreases uric acid production and decreases uric acid
deposits in kidney
How does Rasburicase work? catalyses the conversion of uric acid to allantoin
S/S of hyperkalemia muscle weakness
muscle cramps
bradycardia
tall T waves
, S/S of hypokalemia decreased reflexes
irregular pulse
fatigue
N/V
flat t wave
V fib if severe
Calcium normal range 8.5-10.5 meq/L
S/S of hypercalcemia fatigue
lethargy
muscle weakness
impaired concentration
confusion
constipation
polyuria/polydipsia
