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A woman with a progressively enlarging neck comes into the clinic. She mentions that she has been in a foreign country for the previous 3 months and that she didn't eat much while she was there because she didn't like the food. She also mentions that she becomes dizzy when lifting her arms to do normal household chores or when dressing. What endocrine disorder should the nurse expect the physician to diagnose? DM Goiter Dehydration Cushings Syndrome
Goiter A goiter can result from inadequate dietary intake of iodine associated with changes in foods or malnutrition. It's caused by insufficient thyroid gland production and depletion of glandular iodine. Signs and symptoms of this malfunction include an enlarged thyroid gland, dizziness when raising the arms above the head, dysphagia, and respiratory distress. Signs and symptoms of diabetes mellitus include polydipsia, polyuria, and polyphagia. Signs and symptoms of diabetes insipidus include extreme polyuria (4 to 16 L/day) and symptoms of dehydration (poor tissue turgor, dry mucous membranes, constipation, dizziness, and hypotension). Cushing's syndrome causes buffalo hump, moon face, irritability, emotional lability, and pathologic fractures.
1. How would you assess a pt that developed acute glomerulonephritis?
The primary presenting features of an acute glomerular inflammation are hematuria, edema, azotemia ,and proteinuria, hypertension, malaise, flank pain.
A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of Risk for impaired skin integrity. Which intervention should be part of this client's care plan? A. Avoiding using soap on the irradiated areas B. Wearing a lead apron during direct contact with the client C. Removing thoracic skin markings after each radiation treatment D. Applying talcum powder to the irradiated areas daily after bathing
2A avoiding using soap on the irradiated areas. R.Because external radiation commonly causes skin irritation, the nurse should wash the irradiated area with water only and leave the area open to air. No soaps, deodorants, lotions, or powders should be applied. A lead apron is unnecessary because no radiation source is present in the client's body or room. Skin in the area to be irradiated is marked to position the radiation beam as precisely as possible; skin markings must not be removed
A client sustained a head injury when falling off of a ladder. While in the hospital, the client begins voiding large amounts of clear urine and states he is very thirsty. The client states that he feels weak, and he has had an 8-lb weight loss since admission. What should the client be tested for? A) Diabetes insipidus (DI) B)Syndrome of inappropriate antidiuretic hormone secretion (SIADH) C)Pituitary tumor D)Hypothyroidism
A Diabetes Insipidus Rationale: Urine output may be as high as 20 L/24 hours. Urine is dilute, with a specific gravity of 1.002 or less. Limiting fluid intake does not control urine exertion. Thirst is excessive and constant. Activities are limited by the frequent need to drink and void. Weakness, dehydration, and weight loss develop. SIADH will have the opposite clinical manifestations. The client's symptoms are related to the trauma and not a pituitary tumor. The thyroid gland does not exhibit these symptoms.
A hospitalized, insulin-dependent patient with diabetes has been experiencing morning hyperglycemia. The patient will be awakened once or twice during the night to test blood glucose levels. The health care provider suspects that the cause is related to the Somogyi effect. Which of the following indicators support this diagnosis? Select all that apply.-normal bedtime glucose-elevated blood glucose at bedtime-decrease in blood sugar to hypoglycemic level between 2:00 and 3:00 AM-increase in blood glucose from 3:00am until breakfast-rise in blood glucose about 3:00 AM
-normal bedtime glucose-increase in blood glucose from 3:00 aM until breakfast-DECREASED in blood sugar to hypoglycemic level between 2:00AM -3:00AM Normal bedtime blood glucose; Increase in blood glucose from 3:00 AM until breakfast; Decrease in blood sugar to a hypoglycemic level between 2:00 to 3:00 AM The Somogyi effect is nocturnal hypoglycemia followed by rebound hyperglycemia in the morning. The Somogyi effect occurs when blood glucose is normal or elevated at bedtime, decreases at 2 to 3 a.m. to hypoglycemia levels, and subsequently increases as a result of the production of counter-regulatory hormones.
1. Name a sensitive indicator of renal function? s a sensitive indicator of renal disease progression.
. Creatinine clearance level The creatinine clearance measures the volume of blood cleared of endogenous creatinine in 1 minute. This serves as a measure of the glomerular filtration rate. Therefore the creatinine clearance test is a sensitive indicator of renal disease progression.
11QQ.Anorexia and cachexia are common problems at the end of life. The nurse plays an important role in managing symptoms and preventing complications. Which of the following are appropriate nursing interventions for these problems? Select all that apply.
1. Encourage the patient to eat in an upright position. 2. Recommend that the patient eat when hungry, regardless of usual meal times. 3. Teach the patient how to increase the nutritional value of meals (i.e., add dry milk powder to milk).
1. If a pt just had a brush biopsy 9 hours ago, what finding should the MD be notified?
1. If a pt just had a brush biopsy 9 hours ago, what finding should the MD be notified? Signs and symptoms of infection like fever and chills. After a biopsy procedure, nursing care includes monitoring vital signs for the first 24 hours to detect signs and symptoms of bleeding or infection. The nurse should assess for other signs and symptoms of internal bleeding such as pallor, dizziness, and flank or back pain. IV fluids may be given to help clear the kidneys and prevent clot formation. Urine may contain blood (usually clearing in 24 to 48 hours) from oozing at the site. Bed rest should be maintained and pressure dressings applied for prescribed periods of time to control bleeding. Puncture sites should be examined for signs and symptoms of infection. Analgesic agents should be given as prescribed and needed for pain s/s for infection and bleeding: fever, VS, hematuria, bleeding, renal colic, pallor, dizziness.
1. If your patients Bun and Creatinine test are high what initial diagnostic test might be ordered?
1. If your patients Bun and Creatinine test are high what initial diagnostic test might be ordered? Ultrasound
1.Q.The nurse is to administer a vesicant chemotherapeutic drug to a client who had a right mastectomy and inserts the intravenous line
1.A. w. a soft plastic catheter Vesicant chemotherapy should never be administered in the peripheral veins involving the hand or wrist. A person with breast cancer is to avoid injections in the affected extremity. A soft, plastic catheter should be used, not a butterfly needle.
1. There are three areas of the ureters that have a propensity for obstruction. Prompt management of renal calculi is most important when the stone is located where? A) In the ureteropelvic junction B) In the ureteral segment near the sacroiliac junction C) In the ureterovesical junction D) In the urethra
A) In the ureteropelvic junction Feedback: There are three narrowed areas of each ureter: the ureteropelvic junction, the ureteral segment near the sacroiliac junction, and the ureterovescial junction. These three areas of the ureters have a propensity for obstruction by renal calculi or stricture. Obstruction of the ureteropelvic junction is the most serious because of its close proximity to the kidney and the risk of associated kidney dysfunction. The urethra is not part of the ureter, so option D is incorrect.
A nurse is providing care to a client with primary hyperparathyroidism. Which interventions would be included in the client's care plan? Select all that apply. A. Monitor gait, balance, and fatigue level with ambulation. B. Encourage intake of dairy products, seafood, nuts, broccoli, and spinach. C. Monitor for fluid overload. D. Monitor for signs and symptoms of diarrhea.
A. Monitor gait, balance, and fatigue level with ambulation.C. Monitor for fluid overload. Excessive calcium in the blood depresses the responsiveness of the peripheral nerves, accounting for fatigue and muscle weakness. A large volume of fluid is encouraged to keep the urine dilute. Possible effects include nausea, vomiting, and constipation. Client would be on a calcium-restricted diet.
What pharmacologic therapy does the nurse anticipate administering when the patient is experiencing thyroid storm? (Select all that apply.) Acetaminophen Iodine Propylthiouracil Synthetic levothyroxine Dexamethasone (Decadron)
Acetaminophen Iodine Propylthiouracil Prof says" The nurse anticipates administering what meds when the patient is experiencing thyroid storm? Iodine. Methimazole. Acetaminophen. Hydrocortisone What drugs have proved helpful for a Thyroid storm? · Hydrocortisone · Acetaminophen · Methimazole (tapazole) · Iodine "HAMI"
Which statement about fluid replacement is accurate for a client with hyperosmolar hyperglycemic nonketotic syndrome? Administer IV fluid slowly to prevent circulatory overload and collapse. Administer 10 L of IV fluid over the first 24 hours. Administer 2 to 3 L of IV fluid rapidly. Administer a dextrose solution containing normal saline solution.
Administer 2 to 3 L of IV fluid rapidly. Regardless of the client's medical history, rapid fluid resuscitation is critical for maintaining cardiovascular integrity. Profound intravascular depletion requires aggressive fluid replacement. A typical fluid resuscitation protocol is 6 L of fluid over the first 12 hours, with more fluid to follow over the next 24 hours. Various fluids can be used, depending on the degree of hypovolemia. Commonly ordered fluids include dextran (in cases of hypovolemic shock), isotonic normal saline solution and, when the client is stabilized, hypotonic half-normal saline solution.
Cyclophosphamide (Cytoxan) is an ?
Alkylating agents cause cross-linking of DNA strands, abnormal base pairing, and DNA strand breaks, thus preventing the cell from dividing.
1. What has the greatest potential to reduce an individual's risk for developing diabetes?
Obesity is a major modifiable risk factor for diabetes.
clinical use of tumor markers?
As diagnostic tools, tumor markers have limitations. Nearly all markers can be elevated in benign conditions, and most are not elevated in the early stages of malignancy. SO, tumor markers have limited value as screening tests. Furthermore, they are not in themselves specific enough to permit a diagnosis of a malignancy.
1. To rule out a tumor when a client is complaining of back pain what test might be ordered?
Bone scan A bone scan is the preferred diagnostic procedure to disclose tumors in a patient with low back pain. A computerized tomography will identify soft tissue lesions and vertebral disc problems. Magnetic resonance imaging permits visualization of the nature and location of spinal pathology. An electromyogram is used to evaluate nerve root disorders.
The nurse is caring for a 39-year-old woman with a family history of breast cancer. She requested a breast tumor marking test and the results have come back positive. As a result, the patient is requesting a bilateral mastectomy. This surgery is an example of what type of oncologic surgery? A) Salvage surgery B) Palliative surgery C) Prophylactic surgery D) Reconstructive surgery
C) Prophylactic surgery Prophylactic surgery is used when there is an extensive family history and nonvital tissues are removed. Salvage surgery is an additional treatment option that uses an extensive surgical approach to treat the local recurrence of a cancer after the use of a less extensive primary approach. Palliative surgery is performed in an attempt to relieve complications of cancer, such as ulceration, obstruction, hemorrhage, pain, and malignant effusion. Reconstructive surgery may follow curative or radical surgery in an attempt to improve function or obtain a more desirable cosmetic effect.
1. What is viscosupplementation?
a procedure where a thick fluid called hyaluronate is injected into the knee joint. There are NO CURES for osteoarthritis, so viscosupplementation will not cure osteoarthritis of the knee.
Q A nurse is preparing to administer leucovorin to a client who has cancer and is receiving chemotherapy with methotrexate (Trexall). Which of the following responses is appropriate when the client asks why leucovorin is being given? A. "Leucovorin reduces the risk of a transfusion reaction from methotrexate." B. "Leucovorin increases platelet production and prevents bleeding." C. "Leucovorin potentiates the cytotoxic effects of methotrexate." D. "Leucovorin protects healthy cells from methotrexate's toxic effects."
D. "Leucovorin protects healthy cells from methotrexate's toxic effects." R.Leucovorin is administered with methotrexate to protect normal cells
Why would a patient receive receive Bacille Calmette-Guerin (BCG)?
Early investigations of the stimulation of the immune system involved nonspecific agents such as bacille Calmette-Guérin (BCG) and Corynebacterium parvum. When injected into the patient, these agents serve as antigens that stimulate an immune response. The hope is that the stimulated immune system will then eradicate malignant cells. Extensive animal and human investigations with BCG have shown promising results, especially in treating localized malignant melanoma. In addition, BCG bladder instillation is a standard form of treatment for localized bladder cancer PROF:Serves as antigens that stimulates immune response to eradicate malignant cells.
In an OLDER ADULT, what migh Early symptoms of UTI present like?
Early symptoms of UTI in older adults include burning, urgency, and fever (Eliopoulos, 2018). Some patients develop incontinence and delirium with the onset of a UTI. (Hinkle, 10/2017, p. 1618)
1. What are s/s of severe hyperthyroidism?
Exophthalmos that results from enlarged muscle and fatty tissue surrounding the rear and sides of the eyeball is seen in clients with severe hyperthyroidism
11. Why would a pt with acute renal failure receives an IV infusion of 10 percent dextrose in water with 18 units of regular insulin?
Facilitate the intracellular movement of potassium. Dextrose with insulin helps move potassium into cells and is immediate management therapy for hyperkalemia due to acute renal failure. An exchange resin may also be employed. This type of infusion is often administered before cardiac surgery to stabilize irritable cells and prevent arrhythmias; in this case KCl is also added to the infusion.
A client in acute renal failure receives an IV infusion of 10 percent dextrose in water with 20 units of regular insulin. The nurse understands that the rationale for this therapy is to...
Facilitate the intracellular movement of potassium. Dextrose with insulin helps move potassium into cells and is immediate management therapy for hyperkalemia due to acute renal failure. An exchange resin may also be employed. This type of infusion is often administered before cardiac surgery to stabilize irritable cells and prevent arrhythmias; in this case KCl is also added to the infusion.
Q A nurse is working with a family of a deceased client and assisting them in working through their grief and mourning. Which of the following would be the priority to promote healthy accommodation of the loss by the family?
Helping the family recognize the loss has occurred R. The priority in assisting the family to accommodate the loss of the client in a healthy way is to help them recognize the loss.
A client diagnosed with cancer has their tumor staged and graded based on what?
How they tend to grow and the cell type R. Tumors are staged and graded based upon how they tend to grow and the cell type before a client is treated for cancer.
1. What are the signs/symptoms an elevated serum calcium?
Hypercalcemia is a dangerous complication of bone cancer. The symptoms must be recognized and treatment initiated promptly. Symptoms include muscular weakness, incoordination, anorexia, nausea and vomiting, constipation, electrocardiographic changes (eg, shortened QT interval and ST segment, bradycardia, heart blocks), and altered mental states (eg, confusion, lethargy, psychotic behavior). The major causes of hypercalcemia are hyperparathyroidism; increased mobilization of calcium from bone (as in cancer with metastatic bone lesions); immobilization; and vitamin D intoxication. A low phosphate level will result in higher serum calcium due to the inverse relationship between these two electrolytes. A client taking a loop diuretic is more prone to hypocalcemia as this medication promotes the loss of calcium in urine.
1. Prompt management is required, if the pt kidney stone is located where?
In the ureteropelvic junction. Obstruction of the ureteropelvic junction is the most serious because of its close proximity to the kidney and the risk of associated kidney dysfunction
12.Q.A client was diagnosed with rheumatoid arthritis 1 year ago, but has achieved adequate symptom control with celecoxib, a COX-2 selective NSAID. The nurse should recognize that this drug, like other NSAIDs, influences what aspect of the pathophysiology of nociceptive pain? 1.Distorting the action potential that is transmitted along the A-delta (δ) and C fibers 2.Diverting noxious information from passing through the dorsal root ganglia and synapses in the dorsal horn of the spinal cord 3.Blocking modulation by limiting the reuptake of serotonin and norepinephrine 4.Inhibiting transduction by blocking the formation of prostaglandins in the periphery
Inhibiting transduction by blocking the formation of prostaglandins in the periphery Explanation: NSAIDs produce pain relief primarily by blocking the formation of prostaglandins in the periphery; this is a central component of the pathophysiology of transduction. NSAIDs do not act directly on the aspects of transmission, perception, or modulation of pain that are listed.
8Q. A client is diagnosed with metastatic adenocarcinoma of the stomach. Thephysician orders mitomycin (Mutamycin) and other chemotherapeutic agents forpalliative treatment. How does mitomycin! exert its cytotoxic effects?
It inhibits deoxyribonucleic acid (DNA) synthesis. R. Mitomycin exerts its cytotoxic effects by inhibiting DNA synthesis rather than RNAsynthesis. It's cell cycle-phase nonspecific and doesn't inhibit protein synthesis.
One of the most frequently occurring complications (55% occurrence) of primary hyperparathyroidism is
Kidney Stones Explanation: Kidney stones occur in 55% of patients with primary hyperparathyroidism. They are caused by renal damage from the precipitation of calcium phosphate in the renal pelvis and parenchyma.
Which medication blocks synthesis of thyroid hormone? Dexamethasone Methimazole Potassium iodide Sodium iodide SSKI
Methimazole blocks synthesis of thyroid hormone. Dexamethasone, potassium iodide, and sodium iodide suppress release of thyroid hormone.
4.Q. Which of the following the are early manifestations of liver cancer? Select all that apply.
Pain • Continuous aching in the back Rationale: Early manifestations of liver cancer include pain and continuous dull aching in the right upper quadrant epigastrium or back. Weight loss, anorexia, and anemia may occur. Jaundice is present only if the larger bile ducts are occluded by the pressure of malignant nodules in the hilum of the liver. Fever and vomiting are not associated manifestations.
The nurse is caring for a patient at risk for an addisonian crisis. For what associated signs and symptoms should the nurse monitor the patient? Select all that apply. A) Epistaxis B) Pallor C) Rapid respiratory rate D) Bounding pulse E) Hypotension
Pallor, Rapid RR, Hypotension Feedback:The patient at risk is monitored for signs and symptoms indicative of addisonian crisis, which can include shock; hypotension; rapid, weak pulse; rapid respiratory rate; pallor; and extreme weakness. Epistaxis and a bounding pulse are not symptoms or signs of an addisonian crisis.
Which of the following is generally NOT considered to be a carcinogen?
Parasites R. Carcinogens include chemical agents, environmental factors, dietary substances, viruses, defective genes, and medically prescribed interventions like HRT
A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram? .
Pruritus The nurse should be alert for pruritus and urticaria, which may indicate a mild anaphylactic reaction to the arteriogram dye. Decreased (not increased) alertness may occur as well as dyspnea (not hypoventilation). Unusually smooth skin isn't a sign of anaphylaxis.
What may indicate an allergic reaction to the dye used during the arteriogram?
Pruritus, urticaria, decreased alertness, flushing, dyspnea.
You are an oncology nurse caring for a client who is taking antineoplastic agents. What symptoms must you consider when monitoring this client?
Symptoms of gout R.The nurse monitors the client being administered an antineoplastic agent for symptoms of gout, which include increased uric acid levels, joint pain, and edema. Administering antineoplastic agents does not cause hypertension, diarrhea, and anemia.
The nurse knows that interferon agents are used in association with chemotherapy to produce which effects in the client?
Shorten the period of neutropenia R. Interferon agents are a type of biologic response modifiers (BRMs) used in conjunction with chemotherapy to reduce the risk of infection by shortening the period of neutropenia through bone marrow stimulation. The suppression of bone marrow creates the need for interferon use, not a result of the use. Although some BRMs can inhibit tumor growth, the primary use is for reducing neutropenia. Interferon use does not replace standard cancer treatments or decrease the need for those treatments.
What kind of problems may you see in Lower UTIs?
Signs and symptoms of an uncomplicated lower UTI include burning on urination, urinary frequency ,urgency, nocturia incontinence, and suprapubic or pelvic pain. Hematuria and back pain may also be present. In patients with complicated UTIs, manifestations can range from asymptomatic bacteriuria to gram-negative sepsis with shock. Complicated UTIs often are caused by a broader spectrum of organisms, have a lower response rate to treatment, and tend to recur. Many patients with catheter-associated UTIs are asymptomatic; however, any patient with a catheter who suddenly develops signs and symptoms of septic shock should be evaluated for urosepsis (the spread of infection from the urinary tract to the bloodstream that results in a systemic infection). (Hinkle, 10/2017, p. 1617)
What suppress release of thyroid hormones?
Sodium iodide, potassium iodide, dexamethasone, SSKI suppress the release of thyroid hormones. NOT Methimazole blocks the synthesis of thyroid hormone.
only treatment of osteoporosis in the United States.
Teriparatide (Forteo) is a subcutaneously administered anabolic agent that is taken once daily. abaloparatide ( tymlos) The other drug choices are oral preparations. In principle, stimulating bone formation by pharmacologic means (anabolic therapy) can increase bone mass
Which of the following statements best captures the relationship between the hypothalamus and the pituitary gland as it relates to endocrine function?
The hypothalamus receives input from numerous sources throughout the body and directs the pituitary to then control many target glands and cells. Explanation: The hypothalamus can be viewed as a bridge by which signals from multiple systems are relayed to the pituitary gland. The hypothalamus collects data from sources throughout the body rather than directly measuring levels and communication normally flows from the hypothalamus to the pituitary.
What symptoms would the nurse consider with tumor lysis syndrome when monitoring this client?
The nurse monitors the client being administered an antineoplastic agent for symptoms of gout, which include increased uric acid levels, joint pain, and edema, with the consideration of tumor lysis syndrome.
A patient with elevated BUN and creatinine values has been referred by her primary physician for further evaluation. The nurse should anticipate the use of what initial diagnostic test?
US Feedback: Ultrasonography is a noninvasive procedure that passes sound waves into the body through a transducer to detect abnormalities of internal tissues and organs. Structures of the urinary system create characteristic ultrasonographic images. Because of its sensitivity, ultrasonography has replaced many other diagnostic tests as the initial diagnostic procedure.
1. Explain the the relationship between the hypothalamus and the pituitary gland?
Under the influence of the hypothalamus, the lobes of the pituitary gland secrete various hormones. Many endocrine glands respond to stimulation from the pituitary gland, which is connected by a stalk to the hypothalamus in the brain. Under the influence of the hypothalamus, the lobes of the pituitary gland secrete various hormones. Even though the pituitary gland is called the 'master gland,' the hypothalamus influences the pituitary gland. The pituitary gland is called the 'master gland' because it regulates the function of other endocrine glands.
What kind of problems may you see in Upper UTIs
Upper UTI: chills, fever, leukocytosis, bacteriuria, and pyuria. Low back pain, flank pain, nausea and vomiting, headache, malaise, and painful urination are common findings. CVA tenderness(Hinkle, 10/2017, p. 1622) atrophy and destruction of tubules and the glomeruli may result.
1. Explain function of the kidney.
Urine formation Excretion of waste products Regulation of electrolytes Regulation of acid-base balance Control of water balance Control of blood pressure Renal clearance Regulation of red blood cell production Synthesis of vitamin D to active form Secretion of prostaglandins (Hinkle, 10/2017, p. 1549) Activate growth hormones
What is a microvascular complication of diabetes?
Vision and Renal Myocardial infarction and stroke are considered macrovascular complications of diabetes, while the effects on vision and renal function are considered to be microvascular.
treatments for thyroid storm ( severe hyperthyroidism)
a hypothermia mattress or blanket, ice packs, a cool environment, hydrocortisone, and acetaminophen (Tylenol); propylthiouracil (PTU) or methimazole (me-THIM-a-zole), iodine "HAMI"
Q. a patient is to receive Bacille Calmette-Guerin (BCG), a nonspecific biologic response modifier. why would the patient receive this form of treatment? a. for cancer of the bladder b. for cancer of the breast c. for cancer of the lungs d. for skin cancer
a. for cancer of the bladder
1. What test result help confirm an SLE diagnosis?
above normal anti-dna test others: positive ANA test, Positive lupus eryth. cell test.
5-FU is an ?
antimetabolite. Antimetabolites are cell cycle specific, exerting their effects only in the S phase (DNA synthesis and metabolism) of the cell cycle.
Doxorubicin (Adriamycin) is an ?
antitumor antibiotic. It is also a cell cycle-nonspecific agent, inhibiting protein and RNA synthesis and binding DNA, causing fragmentation.
12. What indicator would you look up for the primary cause of end-stage renal disease?
c) Serum glucose The nurse would evaluate serum and urine levels of glucose because diabetes is the primary cause of renal failure.
.During an annual examination, an older patient tells the nurse, "I don't understand why I need to have so many cancer screening tests now. I feel just fine!" Based on the knowledge of neoplastic disease and the aging immune system, what teaching should the nurse include in the patient's plan of care? Select all that apply. a) The immune system is integrated with other psychophysiologic processes and is regulated by the brain. Aging of the brain can have immunologic consequences and can affect neural and endocrine function increasing the risk of cancer development. b) Tumor cells may possess special blocking factors that coat tumor cells and prevent their destruction by killer T lymphocytes; therefore, the body may not recognize the tumor as foreign and fail to destroy the malignant cells. Routine screening increases the chance of finding and treating cancer early. c) Education about the importance of adhering to a recommended vaccine schedule should be initiated to boost the immune system function. d) Nutritional intake to support a competent immune response plays an important role in reducing the incidence of cancer. A healthy diet including protein, vitamins, minerals, and some fats can alter the risk of cancer development. e) The increase in occurrence of autoimmune diseases due to aging strongly suggests a predisposition to various types of cancer due to the body's inability to differentiate between self and nonself. Routine screening increases the chance of finding and treating cancer early.
b) Tumor cells may possess special blocking factors that coat tumor cells and prevent their destruction by killer T lymphocytes; therefore, the body may not recognize the tumor as foreign and fail to destroy the malignant cells. Routine screening increases the chance of finding and treating cancer early. e) The increase in occurrence of autoimmune diseases due to aging strongly suggests a predisposition to various types of cancer due to the body's inability to differentiate between self and nonself. Routine screening increases the chance of finding and treating cancer early. d) Nutritional intake to support a competent immune response plays an important role in reducing the incidence of cancer. A healthy diet including protein, vitamins, minerals, and some fats can alter the risk of cancer development.
Q.9 Which of the following tumor markers is found in both carcinoma and embryonic tissue and is useful as a prognostic indicator in colorectal carcinoma? a. AFP b. CEA c. PAP d. CA-120
b. CEA
1. When assessing a client for whom there is suspicion of a spinal tumor?
back pain in prone position ( lying flat on stomach)
Based on her knowledge of the primary cause of ESRD, the nurse knows to assess the most important indicator. What is that indicator? a) pH and HCO3 b) Blood pressure c) Serum glucose d) Urine protein
c) Serum glucose The nurse would evaluate serum and urine levels of glucose because diabetes is the primary cause of renal failure.
1. Before hemodialysis, what medications would your hold?
cardiac glycosides, antibiotic agents, antiarrhythmic medications, antihypertensive agents are monitored closely to ensure that blood and tissue levels of these medications are maintained without toxic accumulation. Antihypertensive therapy, often part of the regimen of patients on dialysis, is one example when communication, education, and evaluation can make a difference in patient outcomes. The patient must know when—and when not—to take the medication. For example, if an antihypertensive agent is taken on a dialysis day, hypotension may occur during dialysis, causing dangerously low blood pressure. Many medications that are taken once daily can be held until after the dialysis treatment. (Hinkle, 10/2017, p. 1592) Note: dont hold: phosphate binders, potassium or insulin.
Interventions for acute gout
corticosterioids probenecid serum uric acid pain medications. Steroids may be used in clients who have not responded to other therapies. They have been shown to decrease inflammation and pain in attacks of gout. Probenecid will assist in the excretion of uric acid, the causative agent. Serum uric acid concentrations will guide therapy and treatment. not the dietary consult, as it can wait
1. If your pt is receiving antibiotics An INFECTION and their kidney function is decreases, what will the MD consider when changing the dose of antibiotics?
creatinine clearance to change dosage
10.Explain cutaneous urinary diversion?
cutaneous urinary diversion, urine drains through an opening created in the abdominal wall and skin (Hinkle, 10/2017, p. 1639) the ileal conduit or A cutaneous ureterostomy .
Q. Your patient is receiving carmustine, a chemotherapy agent. A significant side effect of this medication is thrombocytopenia. Which symptom would the nurse assess for in patients at risk for thrombocytopenia?
d) Nose bleed (epistaxis) R. Patients with thrombocytopenia are at risk for bleeding due to decreased platelet counts. A priority goal for this patient is to prevent trauma related to decreased platelet count. A soft toothbrush or an electric razor can be used. No invasive procedures should be performed. Patients with thrombocytopenia do not exhibit interrupted sleep pattern, hot flashes, or increased weight.
A client is transferred to a rehabilitation center after being treated in the hospital for a stroke. Because the client has a history of Cushing's syndrome (hypercortisolism) and chronic obstructive pulmonary disease, the nurse formulates a nursing diagnosis of :a) Decreased cardiac output related to hypotension secondary to Cushing's syndrome. b) Risk for imbalanced fluid volume related to excessive sodium loss. c) Ineffective health maintenance related to frequent hypoglycemic episodes secondary to Cushing's syndrome .d) Risk for impaired skin integrity related to tissue catabolism secondary to cortisol hypersecretion
d) Risk for impaired skin integrity related to tissue catabolism secondary to cortisol hyper secretion. (Cushing's syndrome causes tissue catabolism, resulting in thinning skin and connective tissue loss; along with immobility related to stroke, these factors increase this client's risk for impaired skin integrity. The exaggerated glucocorticoid activity in Cushing's syndrome causes sodium and water retention which, in turn, leads to edema and hypertension.) Therefore, Risk for imbalanced fluid volume and Decreased cardiac output are inappropriate nursing diagnoses. Increased glucocorticoid activity also causes persistent hyperglycemia, eliminating Ineffective health maintenance related to frequent hypoglycemic episodes as an appropriate nursing diagnosis.
1. The effects of chemotherapy two weeks after treatment can result in a fever. Regrowth of hair after alopecia can result in change of hair color, but this effect is not anticipated 2 weeks after treatment. White blood cell count will be decreased 2 weeks after chemotherapy
decreased WBC and fever not hair color and regrowth of hair in 2 weeks.
1. For a patient with Osteomyelitis would might the labs look like?
elevated WBC and ESR
Describe Cushion syndrome and the manifestations?
excessive adrenocortical hormones may cause "moon face," " buffalo hump," thinning of the skin, obesity of the trunk thinness of the extremities, purple striae.
1. How would you assess a pt that developed acute glomerulonephritis?
hematuria, edema, htn, azotemia, proteinuria
what labs might a RN review in osteomalacia?
low ca, low phos, high alk phosphatase in osteomalacia Osteoporosis can be cause due to deficiency of vitamin D, while osteomalacia is caused by a deficiency in calcium and phosphorus. Osteomalacia is characterized by decreased serum calcium and phosphorus and elevated alkaline phosphatase levels.
A patient taking vincristine, an antineoplastic agent that inhibits DNA and protein synthesis, the patient needs to be informed that he should report symptoms that would be an expected side-effect of
motor neuropathy
A client with ovarian cancer is ordered hydroxyurea (Hydrea), an antimetabolite drug. Antimetabolites are a diverse group of antineoplastic agents that interfere with various metabolic actions of the cell. The mechanism of action of antimetabolites interferes with:
normal cellular processes during the S phase of the cell cycle. R:Antimetabolites act during the S phase of the cell cycle, contributing to cell destruction or preventing cell replication. They're most effective against rapidly proliferating cancers. Miotic inhibitors interfere with cell division or mitosis during the M phase of the cell cycle. Alkylating agents affect all rapidly proliferating cells by interfering with DNA; they may kill dividing cells in all phases of the cell cycle and may also kill nondividing cells. Antineoplastic antibiotic agents interfere with one or more stages of the synthesis of RNA, DNA, or both, preventing normal cell growth and reproduction.
1. What is the difference in osteomalacia vs osteoporosis?
osteoporosis: reduction of mass of the bones. osteomalacia is the softening of the bones.
1. Risk Factors associated with an increased risk for osteoporosis include
prep u : Hormones, ETOH, smoking. family history of osteoporosis, chronic low calcium intake, excessive intake of caffeine, tobacco use, Cushing's syndrome, prolonged use of high doses of corticosteroids, prolonged periods of immobility, hyperthyroidism, hyperparathyroidism, eating disorders, malabsorption syndromes, breast cancer (especially if treated with chemotherapy that suppresses estrogen, excluding Tamoxifen, which may reduce the risk of fractures), renal or liver failure, alcoholism, lactose intolerance, and dietary deficiency of vitamin D and calcium. high salt.
What does urine testing include? Urine examination includes the following:
prof says: casts, rbc, glucose, specific gravity and NOT BUN/CREATININE. Urine color (see Table 53-4) Urine clarity and odor Urine pH and specific gravity Tests to detect protein, glucose, and ketone bodies in the urine (proteinuria, renal glycosuria, and ketonuria, respectively) Microscopic examination of the urine sediment after centrifugation to detect RBCs (hematuria), white blood cells (pyuria), casts (cylindruria), crystals (crystalluria), and bacteria (bacteriuria) (Hinkle, 10/2017, p. 1561) The urinalysis provides important clinical information about kidney function diabetes. The urine culture determines whether bacteria are present in the urine, as well as their strains and concentration. Urine culture and sensitivity also identify the antimicrobial therapy that is best suited for the particular strains identified, taking into consideration the antibiotic agents that have the best rate of resolution in that particular geographic region. Appropriate evaluation of any abnormality can assist in detecting serious underlying diseases. (Hinkle, 10/2017, p. 1559)
During the BMT procedure, what does nurse assess?
psychological status. Patients experience many mood swings and need emotional support and help throughout this process. Not these below as they are for chemo: Assessing the patient's blood pressure, urine gravity, and electrolyte levels is important for patients undergoing chemotherapy.
With SIADH, what labs would be abnormal?
serum sodium levels and serum osmolarity are decreased. Urine sodium levels and osmolarity are high
What does Viscosupplementation do?
the intra-articular injection of hyaluronates, is thought to prevent the loss of cartilage and repair chondral defects. It may also have some anti-inflammatory effects. in OA
1. What does Glucosamine and chondroitin do ?
thought to improve tissue function and retard breakdown of cartilage in OA
