HESI Medical Surgical Nursing 2 Questions and Answers Practice
Questions with Solutions Newest | Already Graded A+
Chemotherapy-Renal Failure
Renal System
Some chemotherapy agents damage the kidneys because they impair water
secretion, leading to syndrome of inappropriate secretion of antidiuretic
hormone (SIADH), decrease renal perfusion, precipitate end products after
cell lysis, and cause interstitial nephritis. Cisplatin (Platinol), methotrexate,
and mitomycin
(Mutamycin) are particularly toxic to the kidneys. Rapid tumor cell lysis after
chemotherapy results in increased urinary excretion of uric acid, which can
cause renal damage.
Monitoring laboratory values of blood urea nitrogen (BUN), serum creatinine,
creatinine clearance, and serum electrolytes is essential (Comerford, 2015).
Adequate hydration, diuresis, alkalinization of the urine to prevent formation
of uric acid
crystals, and administration of allopurinol (Zyloprim) may be used to prevent
renal toxicity. Amifostine has demonstrated an ability to minimize renal
toxicities associated with cisplatin, cyclophosphamide (Cytoxan), and
ifosfamide (Ifex) therapy.
Hemorrhagic cystitis is a bladder toxicity that can result from
cyclophosphamide and ifosfamide therapy. Hematuria can range from
microscopic to frank bleeding with
symptoms ranging from transient irritation during urination, dysuria, and
suprapubic pain to life-threatening hemorrhage. Protection of the
bladder focuses on
aggressive IV hydration, frequent voiding, and diuresis. Mesna (Mesnex) is a
cytoprotectant agent that binds with the toxic metabolites of
cyclophosphamide or ifosfamide in the kidneys to prevent hemorrhagic
cystitis
,Chemotherapy Teach
Nurses provide patient and family education that emphasizes two key points:
the importance of adhering to prescribed self-administered premedication
before
presenting to the infusion center, and recognizing and reporting the signs and
symptoms to the nurse once the infusion has started. Patients and
families are also educated about signs and symptoms that may occur at
home following discharge from the infusion area that may warrant
medication administration or immediate
transport to the emergency department for further assessment and treatment.
Radiation Mouth
Alterations in oral mucosa secondary to radiation therapy in the head and
neck region include stomatitis (inflammation of the oral tissues), decreased
salivation and xerostomia (dryness of the mouth), and change in or loss of
taste. Depending on the targeted region, any portion of the gastrointestinal
mucosa may be involved, causing mucositis (inflammation of the lining of
the mouth, throat, and gastrointestinal tract).
Meningitis Symptoms and Hyponatremia
Nuchal rigidity
Kernig's sign, thigh flexed up to abdomen, cannot complete
extend Brudzinski: neck flexed
Vomiting due to increased ICP, hyponatremia can cause brain swelling,
increased ICP
Guillain Barre- Swallow
Patients are at risk for aspiration and dysphagia
, Guillain Barre- Paralysis
Ascending weakness, but they can recover. Good chance they will be
intubated
Myasthenia Gravis- Cold
Avoid Cold, can make symptoms
worse Also can be diagnosed
through ice test
Macular Degeneration Patho
Central vision is affected
Most people older than 60 years have at least a few small drusen, which are
clusters of debris or waste material. When drusen are located in the
macular area, they can affect vision. Patients with AMD have a wide range
of visual loss, but only a small portion experience total blindness. Central
vision is generally the most affected, with most patients retaining
peripheral vision.
Wet is more abrupt onset and more damaging to the vision than
dry Amsler Grid - Several times a week
Questions with Solutions Newest | Already Graded A+
Chemotherapy-Renal Failure
Renal System
Some chemotherapy agents damage the kidneys because they impair water
secretion, leading to syndrome of inappropriate secretion of antidiuretic
hormone (SIADH), decrease renal perfusion, precipitate end products after
cell lysis, and cause interstitial nephritis. Cisplatin (Platinol), methotrexate,
and mitomycin
(Mutamycin) are particularly toxic to the kidneys. Rapid tumor cell lysis after
chemotherapy results in increased urinary excretion of uric acid, which can
cause renal damage.
Monitoring laboratory values of blood urea nitrogen (BUN), serum creatinine,
creatinine clearance, and serum electrolytes is essential (Comerford, 2015).
Adequate hydration, diuresis, alkalinization of the urine to prevent formation
of uric acid
crystals, and administration of allopurinol (Zyloprim) may be used to prevent
renal toxicity. Amifostine has demonstrated an ability to minimize renal
toxicities associated with cisplatin, cyclophosphamide (Cytoxan), and
ifosfamide (Ifex) therapy.
Hemorrhagic cystitis is a bladder toxicity that can result from
cyclophosphamide and ifosfamide therapy. Hematuria can range from
microscopic to frank bleeding with
symptoms ranging from transient irritation during urination, dysuria, and
suprapubic pain to life-threatening hemorrhage. Protection of the
bladder focuses on
aggressive IV hydration, frequent voiding, and diuresis. Mesna (Mesnex) is a
cytoprotectant agent that binds with the toxic metabolites of
cyclophosphamide or ifosfamide in the kidneys to prevent hemorrhagic
cystitis
,Chemotherapy Teach
Nurses provide patient and family education that emphasizes two key points:
the importance of adhering to prescribed self-administered premedication
before
presenting to the infusion center, and recognizing and reporting the signs and
symptoms to the nurse once the infusion has started. Patients and
families are also educated about signs and symptoms that may occur at
home following discharge from the infusion area that may warrant
medication administration or immediate
transport to the emergency department for further assessment and treatment.
Radiation Mouth
Alterations in oral mucosa secondary to radiation therapy in the head and
neck region include stomatitis (inflammation of the oral tissues), decreased
salivation and xerostomia (dryness of the mouth), and change in or loss of
taste. Depending on the targeted region, any portion of the gastrointestinal
mucosa may be involved, causing mucositis (inflammation of the lining of
the mouth, throat, and gastrointestinal tract).
Meningitis Symptoms and Hyponatremia
Nuchal rigidity
Kernig's sign, thigh flexed up to abdomen, cannot complete
extend Brudzinski: neck flexed
Vomiting due to increased ICP, hyponatremia can cause brain swelling,
increased ICP
Guillain Barre- Swallow
Patients are at risk for aspiration and dysphagia
, Guillain Barre- Paralysis
Ascending weakness, but they can recover. Good chance they will be
intubated
Myasthenia Gravis- Cold
Avoid Cold, can make symptoms
worse Also can be diagnosed
through ice test
Macular Degeneration Patho
Central vision is affected
Most people older than 60 years have at least a few small drusen, which are
clusters of debris or waste material. When drusen are located in the
macular area, they can affect vision. Patients with AMD have a wide range
of visual loss, but only a small portion experience total blindness. Central
vision is generally the most affected, with most patients retaining
peripheral vision.
Wet is more abrupt onset and more damaging to the vision than
dry Amsler Grid - Several times a week
