NUR 445 Exam 5 - Module 7 and 8
What is tumor lysis syndrome (TLS)? - answer Rapid cell lysis of tumor, releasing
contents into bloodstream.
What are the manifestations of TLS? - answer Numbness, cardiac dysrhythmias, renal
failure.
What is the most serious complication of TLS? - answer Dysrhythmias, can cause
sudden death.
How is hyperuricemia treated in TLS? – answer Rasburicase if uric acid is already
elevated.
What medication is given to prevent hyperuricemia in high-risk TLS patients? -
answerAllopurinol.
What medication is used for elevated phosphate in TLS? - answerPhosphate binder
(Amphojel).
What should be assessed for signs of renal dysfunction in TLS? - answerElevated BUN,
creatinine, decreased urine output.
What ECG changes should be assessed for in TLS? - answerHeart blocks, peaked T
waves (indicative of dangerous hyperkalemia).
What should be limited in the diet during the risk period of TLS? - answerPotassium and
phosphorus.
What should the diet include during the risk period of TLS? - answerAdequate protein,
carbs, and calories.
What is thrombocytopenia? - answerDecreased platelets below average range (150,000
- 450,000).
What is the main complication of thrombocytopenia? - answerRisk for hemorrhage.
What are two common types of thrombocytopenia? - answerDIC and HIT.
What is disseminated intravascular coagulation (DIC)? - answerHematological disorder
caused by sepsis, burns, cancer, etc.
,What do patients with DIC present with? - answerBoth thrombotic and bleeding
problems.
What causes abnormal coagulation in DIC? - answerFormation of multiple small clots
that consume clotting factors and fibrinogen.
What are the two phases of DIC? - answerThrombotic/clotting phase.
What is the bleeding phase? - answerExcessive bleeding due to inability to form clots.
What is the medical management for excessive bleeding? - answerTreatment of
underlying disorder and other disorders.
What are the manifestations of excessive bleeding? - answerNose bleeds, bleeding at
IV site, gum bleeding, SOB, hypotension, hypoxia, bruising, blood clots, fever, metabolic
acidosis.
How is excessive bleeding treated? - answerTreat the underlying cause, replace clotting
factors, volume replacement, crystalloid solutions, anticoagulant therapy.
What are the bleeding precautions? - answerAvoid rectal thermometer, sex, nose
blows, use soft toothbrush, electric razor, and stool softeners.
What medications are contraindicated due to increased bleeding risk? - answerNSAIDs.
What is HIT? - answerHeparin induced thrombocytopenia - autoimmune allergic
response to heparin.
What are the signs and symptoms of HIT? - answerPetechiae, ecchymosis, nosebleeds,
bleeding gums, black tarry stool, hematuria, decreased platelets.
How is HIT treated? - answerStop heparin administration, use argatroban and lepirudin
as anticoagulants, protamine sulfate as heparin antidote, warfarin is contraindicated.
What is liver disease? - answerDisease affecting the liver.
What is liver trauma? - answerLiver injury often caused by motor vehicle accidents.
What are the symptoms of hepatic insufficiency? - answerJaundice, increased bilirubin,
increased serum transaminase.
What supplements should be taken for liver disease? - answerIron and vitamin
supplements.
What are the labs indicating liver failure? - answerIncrease liver enzymes (ALT, AST),
Increased bilirubin, Increase serum ammonia, Decreased albumin
, What are the risk factors for hepatitis? - answerRisky behaviors (sharing needles,
unprotected sex with multiple partners), Recent travel overseas, Alcohol abuse,
Exposure to some hepatotoxic medications, toxins or autoimmune disease
What is the pathophysiology of hepatitis? - answerInflammation of liver cells due to
virus, Impairs ability to detox, limits protein production and clotting factors, alters ability
to store vitamins, fats and sugars
What are the clinical manifestations of hepatitis? - answerIncreased liver enzymes
(ALT, AST), Increased bilirubin (total and direct), Increased serum ammonia, Decreased
albumin, Jaundice, Abdominal pain
How is hepatitis diagnosed? - answerRecent travel outside U.S
What medications are used for hepatitis? - answerVaccination for Hepatitis A and B
What is the most common reason for liver transplantation in hepatitis C-related
cirrhosis? - answerHepatitis C-related cirrhosis
What are the major complications after liver transplant? - answerOrgan rejection and
infection
What assessments are done for liver transplant patients? - answerIncreased liver
enzymes (ALT and AST), Signs of organ rejection (RUQ pain, changes in bile drainage,
fever, tachycardia, jaundice)
What nursing actions should be taken for hepatitis patients? - answerRefer patient to
social worker for assistance with medication financing
What should be included in the teaching for hepatitis patients? - answerNutritional
teaching (balanced diet, decreased fat and protein), Good hand hygiene to decrease
transmission from fecal-oral route, Avoid behaviors that contribute to transmission
(needle sharing, unprotected sex), Importance of vaccinations to prevent hepatitis A and
B, Safe public water supply and sewage disposal to prevent hep A
What are the risk factors for cirrhosis? - answerChronic infection with Hep A, B or C,
Chronic alcoholism
What is the pathophysiology of cirrhosis? - answerIrreversible chronic cell destruction
and fibrosis/scarring of the hepatic tissue
What is ascites? - answerAccumulation of protein-rich fluid in the abdominal cavity.
What are the signs and symptoms of cirrhosis? - answerShortness of breath, jaundice,
increased abdominal girth, large spleen, elevated liver enzymes, increased risk of
What is tumor lysis syndrome (TLS)? - answer Rapid cell lysis of tumor, releasing
contents into bloodstream.
What are the manifestations of TLS? - answer Numbness, cardiac dysrhythmias, renal
failure.
What is the most serious complication of TLS? - answer Dysrhythmias, can cause
sudden death.
How is hyperuricemia treated in TLS? – answer Rasburicase if uric acid is already
elevated.
What medication is given to prevent hyperuricemia in high-risk TLS patients? -
answerAllopurinol.
What medication is used for elevated phosphate in TLS? - answerPhosphate binder
(Amphojel).
What should be assessed for signs of renal dysfunction in TLS? - answerElevated BUN,
creatinine, decreased urine output.
What ECG changes should be assessed for in TLS? - answerHeart blocks, peaked T
waves (indicative of dangerous hyperkalemia).
What should be limited in the diet during the risk period of TLS? - answerPotassium and
phosphorus.
What should the diet include during the risk period of TLS? - answerAdequate protein,
carbs, and calories.
What is thrombocytopenia? - answerDecreased platelets below average range (150,000
- 450,000).
What is the main complication of thrombocytopenia? - answerRisk for hemorrhage.
What are two common types of thrombocytopenia? - answerDIC and HIT.
What is disseminated intravascular coagulation (DIC)? - answerHematological disorder
caused by sepsis, burns, cancer, etc.
,What do patients with DIC present with? - answerBoth thrombotic and bleeding
problems.
What causes abnormal coagulation in DIC? - answerFormation of multiple small clots
that consume clotting factors and fibrinogen.
What are the two phases of DIC? - answerThrombotic/clotting phase.
What is the bleeding phase? - answerExcessive bleeding due to inability to form clots.
What is the medical management for excessive bleeding? - answerTreatment of
underlying disorder and other disorders.
What are the manifestations of excessive bleeding? - answerNose bleeds, bleeding at
IV site, gum bleeding, SOB, hypotension, hypoxia, bruising, blood clots, fever, metabolic
acidosis.
How is excessive bleeding treated? - answerTreat the underlying cause, replace clotting
factors, volume replacement, crystalloid solutions, anticoagulant therapy.
What are the bleeding precautions? - answerAvoid rectal thermometer, sex, nose
blows, use soft toothbrush, electric razor, and stool softeners.
What medications are contraindicated due to increased bleeding risk? - answerNSAIDs.
What is HIT? - answerHeparin induced thrombocytopenia - autoimmune allergic
response to heparin.
What are the signs and symptoms of HIT? - answerPetechiae, ecchymosis, nosebleeds,
bleeding gums, black tarry stool, hematuria, decreased platelets.
How is HIT treated? - answerStop heparin administration, use argatroban and lepirudin
as anticoagulants, protamine sulfate as heparin antidote, warfarin is contraindicated.
What is liver disease? - answerDisease affecting the liver.
What is liver trauma? - answerLiver injury often caused by motor vehicle accidents.
What are the symptoms of hepatic insufficiency? - answerJaundice, increased bilirubin,
increased serum transaminase.
What supplements should be taken for liver disease? - answerIron and vitamin
supplements.
What are the labs indicating liver failure? - answerIncrease liver enzymes (ALT, AST),
Increased bilirubin, Increase serum ammonia, Decreased albumin
, What are the risk factors for hepatitis? - answerRisky behaviors (sharing needles,
unprotected sex with multiple partners), Recent travel overseas, Alcohol abuse,
Exposure to some hepatotoxic medications, toxins or autoimmune disease
What is the pathophysiology of hepatitis? - answerInflammation of liver cells due to
virus, Impairs ability to detox, limits protein production and clotting factors, alters ability
to store vitamins, fats and sugars
What are the clinical manifestations of hepatitis? - answerIncreased liver enzymes
(ALT, AST), Increased bilirubin (total and direct), Increased serum ammonia, Decreased
albumin, Jaundice, Abdominal pain
How is hepatitis diagnosed? - answerRecent travel outside U.S
What medications are used for hepatitis? - answerVaccination for Hepatitis A and B
What is the most common reason for liver transplantation in hepatitis C-related
cirrhosis? - answerHepatitis C-related cirrhosis
What are the major complications after liver transplant? - answerOrgan rejection and
infection
What assessments are done for liver transplant patients? - answerIncreased liver
enzymes (ALT and AST), Signs of organ rejection (RUQ pain, changes in bile drainage,
fever, tachycardia, jaundice)
What nursing actions should be taken for hepatitis patients? - answerRefer patient to
social worker for assistance with medication financing
What should be included in the teaching for hepatitis patients? - answerNutritional
teaching (balanced diet, decreased fat and protein), Good hand hygiene to decrease
transmission from fecal-oral route, Avoid behaviors that contribute to transmission
(needle sharing, unprotected sex), Importance of vaccinations to prevent hepatitis A and
B, Safe public water supply and sewage disposal to prevent hep A
What are the risk factors for cirrhosis? - answerChronic infection with Hep A, B or C,
Chronic alcoholism
What is the pathophysiology of cirrhosis? - answerIrreversible chronic cell destruction
and fibrosis/scarring of the hepatic tissue
What is ascites? - answerAccumulation of protein-rich fluid in the abdominal cavity.
What are the signs and symptoms of cirrhosis? - answerShortness of breath, jaundice,
increased abdominal girth, large spleen, elevated liver enzymes, increased risk of
