Nurs 4111—Adult Health II - Final Exam Blueprint* 2025

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Nurs 4111—Adult Health II - Final Exam Blueprint* 2025
Cancer
Clinical Assessment
Non-Hodgkin Disease
 Hallmark: Reid-Steinberg Cells**
 Abnormal Proliferation Of Lymphocytes**
 Types: Hodgkin’s, Non-Hodgkin’s
• Affects Lymph Nodes
• Infection
• Bleeding
• Issues With Tonsils
• Back Pain Due To Enlarged Spleen
• Enlarged Lymph Nodes
 Nursing Considerations
 Radiation, Chemo, Infection, Bleeding
Safety
Neutropenia – Low Wbcs, Infection Precautions (Ppe, Monitor People Going In/Out Room,
Teach
Pt Not To Go To Large Social Gatherings, Mask, Monitor Wbc Count, Monitor Temp)
Chemotherapy
 Always Be Sure Of Correct Weight Of Your Pt For Dosing Of Meds
• May Be Anorexia
• May Be Retaining Fluid
 Ppe For Admin Of Cancer Medications
 Make Sure You Know How To Properly Admin Med
 Frequent Skin Assessments For Tissue Breakdown
• Make Sure Pt Has Correct Access To Give Chemo
• Only Takes A Few Min To Have An Infiltrated Iv And Chemo To Get Into Tissue
And Kill Pt Tissue Or Pt
Radiation
 2-3 Days After Admin
• Pt Should Avoid Pregnant Women Or Children
• Sleep Alone (Separate Rooms), No Sex
• Do Not Share Hygiene Products Or Utensils
• Keep Away From Others In General, No Ambulating In Halls
Nursing Considerations/Interventions/Teaching
Radiation
Laryngectomy – Pt/Nurse Communication, Trach Care, Stoma Care
Chemotherapy
 Myelosuppression - Decreased Bone Marrow Activity (Fewer Rbcs, Wbcs, & Platelets)

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 Post Infusion Care – Assess For Tissue Breakdown (Frequent Skin Assessments)
• Make Sure Pt Has Correct Access To Give Chemo
• Only Takes A Few Min To Have An Infiltrated Iv And Chemo To Get Into Tissue
And Kill Pt Tissue Or Pt
Multiple Myeloma
• Malignant Proliferation Of Plasma Cells In The Bone Marrow That Produce An
Abnormal Antibody (Myeloma Protein Or The Bence Jones Protein)
• Causes Decreased Production Of Antibodies And Increased Uric Acid And
Calcium Which Can Lead To Kidney Failure
O Loss Of Appetite O Extreme Bone Pain O
High Risk For Fractures O Primary Bone Pain
Complaints: Back, Rib, Hip O Increased Uric
Acid And Calcium Levels
 S/S: Kidney Injury, Dehydration, Cardiac Changes
 Educate Pt And Keep Safe From Fractures, Monitor Electrolytes And Potential Kidney
Failure
Nutrition – Diet High In Protein & High In Calories
 Avoid High Temp Foods, Spicy Foods, Rough/Irritating Foods
Tumor Lysis Syndrome
 Uric Acid Is Released – Increases Lactic Acid
 Potassium And Phosphate Is Exponentially Released
• Phosphate That High Will Bind To Calcium
• Hyperkalemia, Hyperphosphatemia, Subsequent Hypocalcemia, Hyperuricemia
– Profound Acidosis
 Abdominal Pain
 When Immune System Is So Suppressed Tumors Can Grow
 S/S 24 Hrs After Radiation
 Terrible Muscle Cramping, Diarrhea, N/V, Decrease In Urine Output Secondary To
Increased Uric Acid
 Need Of Massive Iv Hydration, Bicarb Drip To Correct Acidosis
 In Pt With Ph Less Than 7 In The Presence Of 1 System Failure Death Rate Is Almost 90%
Lymphedema – Swelling At/Around Removal Site After Surgical Tx ( Lumpectomy, Simple Or
Radical Mastectomy -Reconstruction)
• No Sticks Or Bp On That Arm
• Dependent Positioning – Keep Arms At Heart Level To Promote Circulation
Gi
Clinical Assessment/Laboratory Considerations
Cirrhosis – Chronic, Progressive Disease Of The Liver
 Destruction Of Liver Cells Leading To Scar Tissue (Tissue That Doesn’t Work)
 S/S - Sob, Puritis (Itchy), Lower Extremity Swelling, Nail Bed Changes, Clubbing, Terry
Nails ( White Nail Beds )
Hepatic Encephalopathy


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