Cancer Care

Which client should the nurse identify as being at the greatest risk for developing cancer? A client diagnosed with influenza A client pregnant with her first child A client who tests positive for sickle cell anemia A client who tests positive for human papillomavirus virus

A client who tests positive for human papillomavirus virus

The client is experiencing a tracheobronchial obstruction from radiation to the thyroid gland. What assessment change is most concerning? Absence of breath sounds Painful swallowing Hyperkalemia Dependent edema

Absence of breath sounds

Can you identify the nursing care that is appropriate for clients experiencing complications associated with cancer treatment? Drag and drop the appropriate interventions for each complication or side effect to the corresponding box. Pericardial Effusion Assess for increasing respiratory distress Monitor for signs of poor perfusion Assess for hypoactive bowel sounds Assess for pupillary change Monitor for increasing fatigue Monitor for aortic murmur Position in Trendelenburg

Assess for increasing respiratory distress Monitor for signs of poor perfusion Monitor for increasing fatigue The nurse should assess vital signs, signs of dyspnea, poor perfusion, and signs of heart failure such as respiratory distress, fatigue, and edema. Assessment of bowel sounds, pupillary change, and aortic murmur is not warranted. Trendelenburg position is not indicated.

Can you identify the nursing care that is appropriate for clients experiencing complications associated with cancer treatment? Drag and drop the appropriate interventions for each complication or side effect to the corresponding box. Leukostasis Assess for signs of occluded microcirculation Monitor white blood cell count Monitor for blurred vision Monitor for bleeding Monitor for decreased urine output Assess for a headache or transient ischemic attack Assess for constipation Implement seizure precautions

Assess for signs of occluded microcirculation Monitor white blood cell count Monitor for blurred vision Monitor for bleeding Monitor for decreased urine output Assess for a headache or transient ischemic attack The nurse needs to be aware of infection, sludging of blood, and thrombosis. This includes monitoring the white blood cell count; and assessing for signs of occluded microcirculation such as blurred vision, headache, transient ischemic attacks, cerebrovascular accidents, dyspnea, poor peripheral perfusion, and oliguria. The nurse should also assess for signs of bleeding.

A patient with lung cancer is diagnosed with superior vena cava syndrome. Which action is most appropriate for this patient? Assessing for signs of fluid overload Assessing for decreased cardiac output Assessing for signs of renal dysfunction Assessing for signs of respiratory distress

Assessing for decreased cardiac output Rationale: Tumor or tumor-involved lymph node compression of the soft-walled superior sea caba results in reduced cardiac output. Therefore, the nurse should assess for decreased cardiac output. Test taking tips: consider the location.

The nurse is conducting a health history interview for a patient who admits to current tobacco use. Which cancers is this patient at risk for developing? Select all that apply. Colon Hepatic Bladder Breast Lung

Bladder Lung

A patient has hematuria, abdominal discomfort, and a distended abdomen. Which condition does the patient most likely have, according to these symptoms? Brain tumor Bladder cancer Cervical cancer Esophageal cancer

Bladder cancer Rationale: hematuria, abdominal discomfort, and a distended abdomen are clinical manifestations of bladder cancer. Test taking tips: consider the symptoms.

Which are warning signs of cancer? Select all that apply. Fatigue Alopecia Change in bowel habits Nagging cough or hoarseness Obvious change in a wart or mole

Change in bowel habits Nagging cough or hoarseness Obvious change in a wart or mole Rationale: remember acronym "CAUTION" symptoms. Test taking tips: consider all types of cancers.

The nurse is caring for a patient with spinal cord compression. Which symptoms demonstrate late stages? Back pain Weakness, numbness, and tingling Inability to distinguish between hot and cold Constipation or incontinence

Constipation or incontinence Rationale: Constipation or incontinence is a late finding of cord compression. Test taking tips: differentiate between early and late stages.

Which clinical manifestations should the nurse anticipate when providing care to a patient who is diagnosed with lung cancer? Select all that apply. Dyspnea Flank pain Hematuria Weight loss Chronic cough

Dyspnea Weight loss Chronic cough

Which clinical manifestations should the nurse anticipate when providing care to a patient who is diagnosed with kidney cancer? Select all that apply. Dyspnea Flank pain Hematuria Weight gain Chronic cough

Flank pain Hematuria

The nurse monitors fluid overload in a patient with cancer-associated syndrome of inappropriate antidiuretic hormone (SIADH). Which condition is the nurse aiming to prevent in this intervention? Dyspnea Heart block Leukostasis Hypertension

Hypertension Rationale: fluid overload can result in hypertension and subsequent heart failure. Therefore, the nurse monitors fluid overload in a patient with cancer-associated SIADH. Test taking tips: antidiuretic hormone imbalances causes fluid volume retention.

Which warning signs are a part of the CAUTION list of symptoms? Select all that apply. Indigestion or difficulty swallowing. A persistent sore that does not heal. An infection that takes multiple rounds of antibiotics. A change in a wart or mole that are obvious. Hoarseness or nagging cough.

Indigestion or difficulty swallowing. A persistent sore that does not heal. A change in a wart or mole that are obvious. Hoarseness or nagging cough.

A nurse is teaching about carcinogens. Which example indicates a need for further teaching? Human papilloma virus Tobacco Sun exposure Nonionizing radiation

Nonionizing radiation Rationale: nonionizing radiation is relatively low-energy radiation that does not have enough energy to ionize atoms or molecules, unlike ionizing radiations like gamma rays. So, it does not have the ability to cause cancer. Examples of non ionizing radiation include microwaves, radio waves, infrared radiation, visible light, and lasers. Test taking tip: find the incorrect answer.

Which should the nurse include in the teaching plan for a patient who is prescribed external beam radiation therapy in the treatment of cancer? Restricting visitation Not washing off treatment ink tattoos Pre-medicating with diphenhydramine Maintaining intravenous access throughout treatment

Not washing off treatment ink tattoos

Which symptom is common with the cancer complication of pericardial effusion? Leukostasis Respiratory distress Hypercalcemia Bowel obstruction

Respiratory distress

The client is experiencing hypercalcemia from bone metastasis. What symptoms will the nurse anticipate? Select all that apply. Hypotension Muscle weakness Bradycardia Polyuria Prolonged capillary refill

Muscle weakness Bradycardia Polyuria

A nurse is educating patients about cancer prevention. Which cancer prevention measure stated by one of the patients indicates a need for further teaching? Select all that apply. "I should include 150 minutes of vigorous activity per week." "I should ensure that as a woman I do not consume more than two drinks per day." "I should avoid exposure to known carcinogens such as tobacco." "I should try to maintain a healthy weight." "I should eat a starch-based diet to stay healthy."

"I should include 150 minutes of vigorous activity per week." "I should ensure that as a woman I do not consume more than two drinks per day." "I should eat a starch-based diet to stay healthy." Rationale: to prevent cancer, an individual should engage in regular physical activity that is at least 150 mins of moderate activity or 75 mins of vigorous activity per week. An individual should limit consumption of alcoholic beverages to no more than one drink per day for women and no more than two drinks per day for men.An individual should have a healthy diet, preferably a plant-based diet. A plant-based diet is known for reducing the risk of cancer. Refer to Box 13.2 Cancer Prevention Measures. Test taking tips: Find the incorrect answer.

Can you identify the nursing care that is appropriate for clients experiencing complications associated with cancer treatment? Drag and drop the appropriate interventions for each complication or side effect to the corresponding box. Tracheobronchial Obstruction Assess for dependent edema Administer prescribed bronchodilators Monitor for hypoxemia Monitor for hyperkalemia Administer prescribed potassium supplements Assess for absent breath sounds Monitor for diminished chest excursion

Administer prescribed bronchodilators Monitor for hypoxemia Assess for absent breath sounds Monitor for diminished chest excursion Tracheobronchial obstruction is an oncologic emergency associated with lung cancer. When providing care for a client with this issue, the nurse should immediately administer prescribed bronchodilators and monitor for hypoxemia. In severe and late state obstruction, breath sounds are absent and chest excursion is reduced. Dependent edema and hyperkalemia are not anticipated clinical manifestations associated with this medical emergency.

What is true regarding bowel obstruction in a patient with colon cancer? It can happen due to masses in bowel lumen. It can happen due to internal compression. It can happen due to excess antidiuretic hormone. It can happen due to excessive immature white blood cells.

It can happen due to masses in bowel lumen. Rationale: masses in bowel lumen may obstruct the normal flow of enteral contents, gastrointestinal (GI) fluids and wastes, and may result in bowel obstructions. Bowel obstruction is an oncological emergency that is most commonly seen in patients with colon cancer. Test taking tips: bowel obstruction occurs when the small intestine or colon is partially or completely congested.

Which is a common site for metastasis that the nurse should include in the plan of care for a patient who is diagnosed with thyroid cancer? Lung Liver Bladder Rectum

Lung

Can you identify the nursing care that is appropriate for clients experiencing complications associated with cancer treatment? Drag and drop the appropriate interventions for each complication or side effect to the corresponding box. Spinal Cord Compression Monitor for constipation or incontinence Assess for headache Assess for back pain Monitor for pupil changes Monitor for weakness, numbness, and tingling Place on fall precautions Monitor for seizures

Monitor for constipation or incontinence Assess for back pain Monitor for weakness, numbness, and tingling Place on fall precautions With spinal cord compression, the nurse should assess for back pain, weakness, numbness and tingling, unsteady gait, and the loss of ability to distinguish hot and cold. Depending on level of compression, assess for constipation or incontinence. The client should not experience headache, pupil changes, or seizures.

Can you identify the nursing care that is appropriate for clients experiencing complications associated with cancer treatment? Drag and drop the appropriate interventions for each complication or side effect to the corresponding box. Syndrome of Inappropriate Antidiuretic Syndrome Assess for bradycardia Monitor for hypertension Monitor sodium levels Monitor for dilute urine Place on seizure precautions Limit fluid intake Assess for confusion

Monitor for hypertension Monitor sodium levels Place on seizure precautions Limit fluid intake Assess for confusion For SIADH, the nurse should assess for signs of fluid overload such as tachycardia, hypertension, and hyponatremia such as confusion, seizures, and coma. Fluid restriction is important as is the administration of medication as ordered. The urine will be concentrated. Seizure precautions are important because of hyponatremia and cerebral edema.

Can you identify the nursing care that is appropriate for clients experiencing complications associated with cancer treatment? Drag and drop the appropriate interventions for each complication or side effect to the corresponding box. Superior Vena Cava Syndrome Monitor for signs of poor perfusion Monitor for signs of decreased cardiac output Monitor for hypertension Assess for dyspnea Assess for confusion Monitor for edema of the neck, face, and eyes Monitor for bradycardia

Monitor for signs of poor perfusion Monitor for signs of decreased cardiac output Assess for dyspnea Assess for confusion Monitor for edema of the neck, face, and eyes Early assessment changes include dyspnea, edema of neck, face and eyes (most severe in the morning), and prominent upper body vasculature. For later symptoms assess for signs of poor perfusion and decreased cardiac output such as confusion, cyanosis, hypotension, tachycardia.

Can you identify the nursing care that is appropriate for clients experiencing complications associated with cancer treatment? Drag and drop the appropriate interventions for each complication or side effect to the corresponding box. Hypercalcemia Monitor for symptoms of delirium Assess urine output Monitor for decreased peripheral perfusion Assess for muscle weakness Treat nausea and constipation Monitor heart rate for bradycardia Assess for hypotension

Monitor for symptoms of delirium Assess urine output Assess for muscle weakness Treat nausea and constipation Monitor heart rate for bradycardia The nurse should monitor calcium, phosphorous, and renal function. Assess for symptoms of hypercalcemia such as delirium, somnolence, muscle weakness, fatigue, polyuria, bradycardia, nausea, and constipation. Blood pressure and perfusion are not impacted.

Can you identify the nursing care that is appropriate for clients experiencing complications associated with cancer treatment? Drag and drop the appropriate interventions for each complication or side effect to the corresponding box. Bowel Obstruction Monitor parenteral nutrition Administer enteral nutrition Assess breath sounds Assess for nausea and vomiting Administer prescribed bisphosphonates Assess for hyperactive bowel sounds before Assess for hypoactive bowel sounds after

Monitor parenteral nutrition Assess for nausea and vomiting Assess for hyperactive bowel sounds before Assess for hypoactive bowel sounds after Bowel obstruction is an oncologic emergency that most commonly occurs with cancers that affect the bowel or abdomen, such as colon, pancreatic, ovarian, hepatic, and prostate cancers. Clinical management includes parenteral nutrition. Nursing implications include assessing for nausea and vomiting. Enteral nutrition is not administered. Pharmacologic treatment may include peristaltic stimulants if the bowel obstruction is not complete. Bisphosphonates are prescribed for hypercalcemia, not a bowel obstruction. Bowel sounds are increased prior to the obstruction and diminished or absent after the obstruction.

A nurse is caring for a patient with acute myelocytic leukemia who has been admitted to the oncology department due to leukostasis. What are the most important nursing interventions for this patient? Select all that apply. Monitor white blood cell count. Assess for signs of occluded microcirculation. Monitor calcium, phosphorous, and renal function. Assess for edema of the face and eyes. Assess for signs of bleeding.

Monitor white blood cell count. Assess for signs of occluded microcirculation. Assess for signs of bleeding. Test taking tips: consider bleeding, clotting, and infection.