The nurse assesses the patient that has recently finished chemotherapy & radiation & sees the following. What is it & what other info do you want?
Petechia, dot like rash caused by microbleeds under the skin. Assess for other s/s or reports of bleeding. Review labs.
The nurse notes the patient has decreased oral intake x 48 hours. On assessment the nurse notes the following. What is this called & what causes it?
Stomatitis or oral mucositis. This can be caused by cancer treatment (chemo/radiation) or severe neutropenia.
The nurse is caring for a patient with a large mediastinal mass. The patient reports their face, neck & shoulders are swollen every morning. What's wrong with this patient?
Suspicious for superior vena cava syndrome. Can you think of the causes & treatments?
The nurse is caring for a patient that started chemo 24 hours ago for a large lung tumor. CMP results are: K+ 6.8, Uric acid 12, phosphorus 7.7, Ca+ 7.1, creatinine 3. What is likely wrong with this patient?
Tumor Lysis Syndrome
A patient with prostate cancer is scheduled to begin radiation therapy with implanted radiation seeds. What is the name of this type of radiation?
Brachytherapy
A post allogenic transplant patient asks about his ANC & if he is still neutropenic. Labs: WBC 1600, segs 48%, bands 5%. IS he neutropenic?
ANC = 848, yes he is neutropenic.
The experienced nurse is teaching the novice nurse about infection prevention in the oncology patient. What are some things she needs to include in her teaching?
Answers vary: wash/sanitize your hands, aseptic or sterile technique, remove invasive lines ASAP, neutropenic precautions
The patient states the doctor told her "your counts have reached their nadir" and wants to know what that means. How should the nurse respond?
Your counts have hit their lowest levels.
The nurse is caring for a patient with lung cancer that has new onset blurred vision, headache, confusion, and impulsivity. The provider orders an MRI of the brian what is the rationale for this order?
To investigate the cause, especially the potential for metastatic disease to the brain.
An oncology patient is scheduled for a central line to be placed. The patient asks what's the difference between this & a regular IV? How should the nurse respond?
Answers will vary: This is a longer, thicker more durable IV, can be used to give meds & draw labs. The care of this line is sterile. There are risks.
The nurse is caring for a patient receiving chest wall radiation for lung cancer. The patient has dry, scaly, peeling skin in the radiation area. What is this and how can the patient take care of it at home?
Dry desquamation. Wash with mild soap & water daily, avoid friction and trauma. Silicone or silver dressings. No metal on skin during the XRT. Use what XRT says
The nurse is caring for a patient scheduled to begin chemotherapy today. The patient reports they are terrified of being nauseated from the treatment. Name 2 things the nurse can teach the patient regarding nausea.
Answers will vary. Can teach pt about the drug they will receive, PRN/scheduled meds or alternative tx to control N/V, factors that cause nausea.
The nurse is caring for a patient with a history of chest radiation that now presents with substernal chest pain, muffled heart sounds, low voltage QRS & heart palpitations. Which oncology emergency does the nurse suspect?
Cardiac tamponade
The nurse is discussing factors that "promote cancer" during a health fair. Name 2 items the nurse should include.
Answers will vary. This is essentially avoidable risk factors like smoking, poor diet/lack of exercise, over exposure to UV light, ETOH use. Unavoidable - aging
The nurse is caring for a neutropenic patient. The patient's family member asks what can the patient not have to eat. Name 2 food items the patient has to avoid.
Answers will vary. Leftovers >72h old, unpasturized milk, juice & cheese, cold deli meat, uncooked meat, aggregate fruits, unwashed fruit/veggies, certain H2O.
