Download Oncology Nursing Exam Prep: Key Concepts and Verified Answers and more Exams Nursing in PDF only on Docsity!
OCN Study Guide Exam 347 Questions with Verified
Answers
Pleural Effusion - CORRECT ANSWER fluid in pleural space pneumothorax - CORRECT ANSWER air in the pleural space Which chemo has a high risk for pulmonary toxicity? - CORRECT ANSWER bleomycin (Blenoxane) For which pulmonary toxicity does bleomycin have a high risk? - CORRECT ANSWER Pneumonitis Hypocapnia - CORRECT ANSWER reduced carbon dioxide in the blood Signs and Symptoms of pleural effusion - CORRECT ANSWER tachypnea (fast breathing) decreased breath sounds dullness to percussion Define Lymphedema - CORRECT ANSWER obstruction of lymphatic system that caused overload of lymph in the interstitial space
Define Edema - CORRECT ANSWER fluid in the interstitial space Cancer most commonly associated with lymphedema - CORRECT ANSWER Breast Stage 1 Lymphedema - CORRECT ANSWER less than 3 cm difference pitting edema Stage 2 Lymphedema - CORRECT ANSWER 3-5 cm difference skin stretched and shiny nonpitting Stage 3 Lymphedema - CORRECT ANSWER greater than 5 cm difference skin discolored, stretched, firm nonpitting Lymphedema treatment - CORRECT ANSWER compression garment manual lymphatic drainage elevation aerobic exercise with strength training low sodium diet Sentinel lymph node dissection - CORRECT ANSWER removal of the first lymph
What med can be used to protect heart against effects of doxorubicin - CORRECT ANSWER Dexrazoxane Spiral CT - CORRECT ANSWER Diagnostic test for pulmonary emboli D-DImer test - CORRECT ANSWER used to diagnose or rule out conditions that cause hypercoagulability (inappropriate clotting) DIC - CORRECT ANSWER Accelerated activation of the coagulation cascade. Clots form in random places leaving the body open to bleeding without protection Platelet count, Fibrinogen level, D Dimer, FDP Titer - CORRECT ANSWER Tests to diagnose DIC How to treat DIC - CORRECT ANSWER Treat underlying cause What does FFP do? - CORRECT ANSWER Contains all of the clotting factors except platelets. Used to supplement red blood cells when whole blood is not available or to correct a bleeding problem of unknown cause. It is also used to correct DIC. Most common cancer associated with DIC? - CORRECT ANSWER Leukemia, specifically APL Signs/Symptoms of DIC - CORRECT ANSWER bleeding from 3 unrelated sites
hypoxia SOB fever mottled extremities Causes of DIC - CORRECT ANSWER Delivery (of baby) Infection Cancer How does Heparin help DIC? - CORRECT ANSWER Interferes with thrombin production. Maintain PTT at 1-2 times the normal level (18-28 seconds) S/S of septic shock - CORRECT ANSWER Fever Tachycardia Hypotension Most common cause of sepsis - CORRECT ANSWER Gram (-) bacteria DIC - CORRECT ANSWER Accelerated activation of the coagulation cascade. Clots form in random places leaving the body open to bleeding without protection Platelet count, Fibrinogen level, D Dimer, FDP Titer - CORRECT ANSWER Tests to diagnose DIC
S/S of septic shock - CORRECT ANSWER Fever Tachycardia Hypotension Most common cause of sepsis - CORRECT ANSWER Gram (-) bacteria Granulocytopenia - CORRECT ANSWER failure of the bone marrow to make enough white blood cells (neutrophils) Highest risk factor for sepsis - CORRECT ANSWER Prolonged granulocytopenia (less than 500/mm3) What cancer commonly produces TLS? - CORRECT ANSWER High grade lymphoma Define Tumor Lysis Syndrome (TLS) - CORRECT ANSWER metabolic imbalance that occurs with rapid tumor kill Lab results indicating DIC - CORRECT ANSWER Increased D Dimer Increased FDP Decreased fibrinogen Decreased platelets
Lab results indicitave of TLS - CORRECT ANSWER 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 - CORRECT ANSWER K Phos Uric Acid Calcium LDH Renal function (BUN, Creatinine) How to treat severe hyperkalemia - CORRECT ANSWER hypertonic glucose and insulin. Shifts extracellular K back into intracellular stores How does Allopurinol work? - CORRECT ANSWER decreases uric acid production and decreases uric acid deposits in kidney How does Rasburicase work? - CORRECT ANSWER catalyses the conversion of uric acid to allantoin
S/S of hypocalcemia - CORRECT ANSWER diarrhea neuromuscular irritability (Chvostek's sign) tingling of fingers and toes seizures Potassium normal range - CORRECT ANSWER 3.5-5.0 meq/L Sodium normal ranges - CORRECT ANSWER 135-145 meq/L S/S of hypernatremia - CORRECT ANSWER polydipsia low grade fever dry skin dry/sticky mucous membrane S/S of mild hyponatremia - CORRECT ANSWER anorexia HA N/V S/S of moderate hyponatremia - CORRECT ANSWER nausea weakness anorexia
fatigue muscle cramps S/S of severe hyponatremia - CORRECT ANSWER seizures AMS First treatment for hyponatremia - CORRECT ANSWER Fluid restrict 500-1000 ml per day Magnesium normal range - CORRECT ANSWER 1.8-2.4 mg/dl S/S of hypermagnesia - CORRECT ANSWER lethargy flushing diaphoresis S/S of hypomagnesia - CORRECT ANSWER similar to hypocalcemia neuromuscular and CNS changes seizures SIADH - CORRECT ANSWER syndrome characterized by excessive release of antidiuretic hormone (ADH or vasopressin)
SVCS diagnostic tests - CORRECT ANSWER CT and MRI Tx of SVCS - CORRECT ANSWER RT, chemo, steroids, surgery Cushings Triad - CORRECT ANSWER HTN bradycardia abnormal respirations Pupil changes in ICP - CORRECT ANSWER unequal, dilated, pinpoint, nonreactive Cardiac tamponade definition - CORRECT ANSWER excessive fluid in pericardial space decreases hearts ability to fill and pump Cardiac Tamponade s/s - CORRECT ANSWER muffled heart sounds weak apical pulse mild tachycardia mild peripheral edema Pericardial effusion diagnostic test - CORRECT ANSWER 2-D echo Define spinal cord compression - CORRECT ANSWER Compression of the thecal sac
by a tumor in the epidural space Cauda Equina - CORRECT ANSWER structure within the lower end of the spinal column, that consists of nerve roots and rootlets Most common loca for malignant invasion of spinal cord that cause SCC - CORRECT ANSWER Outside of the spinal cord (extradural) Most common early symptom of SCC - CORRECT ANSWER neck or back pain Progression of SCC symptoms - CORRECT ANSWER pain motor weakness sensory loss motor loss Pain during SCC usually occurs during what position? - CORRECT ANSWER Lying down supine Diagnostic tests for SCC - CORRECT ANSWER Plain Xray bone scan MRI CT scan
Dysplasia - CORRECT ANSWER loss of uniformity in the appearance of cells Define hematopoesis - CORRECT ANSWER body's ability to regulate, produce, and develop cells Define immune surveillance - CORRECT ANSWER The body's ability to scan for and destroy malignant or altered cells Hematopoesis begins with which cell? - CORRECT ANSWER Pluripotent stem cells Monoclonal Antibodies Fab vs Fc - CORRECT ANSWER Fab is the antigen binding site. Fc signals cells to destroy the cell it is bound to Which antineoplastic categories of drugs are nonspecific? - CORRECT ANSWER Alkylating Nitrosureas Antitumor antibiotics Hormonal therapies What is AUC? - CORRECT ANSWER Amount of drug exposure or total drug concentration over time.
What percent of patients receiving below diaphragm RT have sterility? - CORRECT ANSWER 25% What dose of radiation will affect serility in: Males? Females? - CORRECT ANSWER Males: 4 cGy temp 5 cGy permanent Females
40 yrs, 20 cGy over 5-6 weeks < 40 yrs, 6 cGy Chemos that affect fertility - CORRECT ANSWER Lomustine Doxorubicin Melphalan Cyclophosphamide 5FU Cytarabine What chemos are worst for use 1st trimester of pregnancy? - CORRECT ANSWER
Hyperplasia (increase in cells) Late effects of RT on CNS - CORRECT ANSWER Stroke Blindness Late effects of RT on chest - CORRECT ANSWER Breast Ca soft tissue sarcoma dysphagia pulmoanry fibrosis Late effects of RT of Head/Neck - CORRECT ANSWER hypo or hyperthyroid mandibular osteonecrosis alopecia cavities decreased hearing Late effects of RT on Heart - CORRECT ANSWER pericarditis CAD cardiomyopathy pericardial effusion MI
Late effects of RT on Liver - CORRECT ANSWER Fibrosis cirrhosis Late effects of RT on Ovaries - CORRECT ANSWER failure premature menopause Late effects of RT on Skeletal - CORRECT ANSWER Late fx osteonecrosis Late effects of RT on Skin - CORRECT ANSWER fibrosis necrosis basal cell hyperpigmentation Late effects of RT on testicles - CORRECT ANSWER oligospermia azoospermia decreased testosterone Late effects of RT on urinary - CORRECT ANSWER fibrosis strictures Late effects of RT on testicles - CORRECT ANSWER oligospermia
