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What are the normal lab values for Hgb?
12-18
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What are the normal lab values for Hct?
37-52
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What is a biopsy?
Removal of a piece of tissue for examination & to establish a diagnosis
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What are the three types of biopsies?
Incisional, excisional & needle aspiration
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What is an incisional biopsy?
Removal of a portion of tissue
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What is an excisional biopsy?
Removal of a complete lesion/tumor
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What is a needle aspiration biopsy?
Aspiration of fluid or tissue
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What does an elevation of alkaline phosphatase indicate?
Metastasis to the bone or liver
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What does an increase in serum calcium indicate?
Cancer of the thyroid
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What must a pt NOT do the night before a serum calcitonin level test?
Eat or drink
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When does production of CEA stop?
Before birth
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What type of cancer causes an increase in carcinoembryonic antigen?
Colorectal cancer
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What does the PSA blood marker indicate?
Prostate cancer
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What does the CA-125 marker indicate?
Ovarian cancer
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What is the normal lab value for PSA?
0-4
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What is PSA most widely used for?
To determine effectiveness of cancer treatment
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What is the normal lab value for CA-125?
35
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What must a person NOT eat for the prior 4 days before a stool exam?
Red meat, turnips, melons, aspirin, vit C
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How many stools must an occult be tested on?
3 consecutive
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What is palliative treatment?
Therapy designed to relive or reduce the intensity of uncomfortable symptoms, but that does not produce a cure
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When is radiation treatment used?
For cancer in lymph nodes or to treat tumors that cannot be remove
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What should the pt be taught regarding external radiation?
Avoid sunlight & direct heat or cold to the affected area
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What type of diet is indicated in a pt receiving external radiation?
High protein, high calories, 2-3 q of water
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Where should the nurse stand when treating a pt with internal radiation?
The greatest distance away from the site, at least 6 feet
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Who should not visit internal radiation implant patients?
Kids under 18 & pregnant women
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When cancer of the cervix is treated with a radioactive applicator, how is the patient positioned?
Supine with head of bed no higher than 45 degrees
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What type of diet is indicated for a pt with a radioactive applicator?
Low-residue to minimize perstalsis
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What is kept in the room of a pt treated with radioactive applicator?
Long-handled forceps & a special lead container
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What are the risk factors associated with cancer?
Smoking, dietary habits, exposure to radiation, exposure to environment and chemical carcinogens, smokeless tobacco, & alcohol
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What diets are attributable to cancer?
High-fat, low fiber
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How is a person exposed to radiation everyday?
By the sun
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How does chemotherapy work?
By interfering with the cells� ability to multiply or reproduce
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What is a common problem for a pt receiving chemo?
Leukopenia
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Where is most transplantation bone marrow obtained from?
Posterior iliac crest
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How much bone marrow is extracted?
600-2500 ml
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How long can bone marrow be kept?
3 years
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What is a syngenic bone marrow transplant?
A donation from an identical twin
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What is stomatitis?
A mouth inflammation due to destruction of normal cells
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What type of diet is indicated for a pt with stomatitis?
Soft or liquid
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What is cachexi?
ill health and malnutrition marked by emaciation & associated with cancer
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What is the best approach in dealing with a pt with terminal cancer?
Honestly & openly
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What is the primary focus of hospice?
To enhance the quality of life
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What must the nurse take advantage of in the pt with terminal cancer?
Time available to promote self-care
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When caring for a pt with terminal cancer, what must be written on the care plan?
Plans for pt education
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What is the goal in discharge planning with the pt with terminal cancer?
Continuity of care
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What are the warning signs of cancer?
- Changes in bowel/bladder habits
- A sore throat that does not heal
- Unusual bleeding or discharge
- Thickening lump
- Indigestion or difficulty swallowing
- Obvious change in warts or moles
- Nagging cough or hoarseness
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When should a women perform a breast self exam?
2-3 days after her period ends
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When should a man check his scrotum?
Monthly, after a warm bath or shower
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What does a temp of 100 or more indicate in the pt receiving chemo?
An impending infection
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What is one of the most common complications of the mouth of a chemo pt?
Swallowing problems and systemic infections
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What should the chemo pt rinse their mouth with every 2-4 hours?
Normal saline or sodium bicarbonate
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What should the pt taking chemo do to prevent lung infection?
Cough, deep breathe, use incentive spirometer
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What two types of colony-stimulating factors can prevent or manage neutropenia?
G-CSF & GM-CSF
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Why is fatigue a major problem for pts on chemo who have anemia?
Decreased oxygenation to tissues from the decreased hemoglobin
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What is tumor lysis syndrome?
Rapid lysis of malignant cells as a result of chemotherapy
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What nutritional problems most frequently occur in the pt with cancer?
Malnutrition, anorexia, stomatitis, altered taste sensation, nausea, vomiting, diarrhea, and mucositis
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What can happen to a pt who is inadequately nourished?
Their normal cells will not be able to recover and the immune system will be depleted
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What foods are suggested to facilitate repair and regeneration of cells?
High-calorie
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When should a nurse suggest to the physician the need for a nutritional supplement?
As soon as a 5% weight loss is noted
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Why does a cancer pt experience an alteration in taste sensation?
Cancer cells release substances that resemble amino acids and stimulate the bitter taste buds
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What is checked in a CBC?
RBC, WBC, Platelet, Hgb, Hct
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What does a PT indicate?
Rapidity of blood clotting
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What are the normal lab values for a PT?
11-12.5 seconds
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What are the normal lab values for INR?
.7-1.8
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What does a PTT indicate?
Fibrin clot formation
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A pt presents with mouth pain 10 days after chemo. On inspection, the nurse finds the inside of the mouth is erythematous, edematous, and try. What is this condition?
Stomatitis
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A pt has metastatic breast cancer with involvement of her L5 vertebral body. She is paralyzed from the waist down with incontinence of stool and urine. She is undergoing radiation for spinal cord compression. What is an appropriate nursing diagnosis?
Risk for impaired skin integrity, related to prolonged immobility and
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incontinenceA pt with colon cancer is receiving combined radiation and chemo and is suffering from diarrhea. What is this related to?
Treatments irritating effect on the mucosa of the GI tract
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What is the current recommendation for first-time baseline mammogram in asymptomatic women?
Ages 35-39
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To maintain optimal pain control in a pt with terminal lung cancer, when should the scheduling of oral analgesics generally be?
At scheduled intervals
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What are increasingly important with the growing population of cancer survivors?
Cancer preventions and health promotion behaviors for pt with a diagnosis of cancer
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A pt receiving chemo is anemic and has petechiae and ecchymoses scattered over her upper trunk, especially in her arms. What is this patient experiencing?
Bone marrow suppression
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What statement would indicate a pt understands discharge teaching concerning leucopenia?
�I should avoid close contact with people who might give me an infection.�
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What test will be used to make a definite diagnosis of a benign or malignant tumor of the breast?
Biopsy
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What risk factor is considered significant in the cause of several type of cancer?
Smoking
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What is a biologic modifier that is used prophylactically for patients at risk for neutropenia?
Colony stimulating factor (CSF)
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What is the most preventable cause of death from lung cancer?
Cessation of smoking
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What complication is the result of aggressive chemo that causes a destruction of a large number of rapidly dividing malignant cells?
Tumor lysis syndrome
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What would the nurse do for the pt who has a vaginal radiation implant in place?
Monitor vital signs every 4 hours and report temp greater than 100
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What would be the nurse�s primary concern for a pt with oat cell carcinoma of the lung whose WBC is 1.5?
Prevention of infection
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What are the characteristics of cachexia?
Poor health, malnutrition, and wasting
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What is a priority nursing intervention for a pt with multiple myeloma?
Encouraging fluids
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What lab value would the nurse specifically note as a result of the massive cell destruction that occurs with chemo?
Increased uric acid level
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What is the most common side effect of the pt who is receiving radiation to the neck for cancer of the larynx?
Sore throat
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When caring for a client with an internal radiation implant, the nurse should observe what principle?
Pregnant women are not allowed into the client�s room
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While giving care to a pt with an internal cervical radiation implant, how does the nurse handle the implant she found in the bed?
Pick up the implant with long-handled forceps and place into a lead container
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What is included in the plan of care for a pt who is experiencing hematological toxicity as a result of chemo?
Restrict fresh fruits and veggies in the diet
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What is the priority to monitor in a pt who is receiving chemo with a platelet count of 10,000?
Level of consciousness
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What findings would the nurse expect to document in the pt with suspected Hodgkins?
Enlarged lymph nodes
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What symptom is typical of ovarian cancer?
Abdominal distention
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What findings would indicate that the pt is experiencing a complication relate to a radical masectomy?
Arm edema on the operative side
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What discharge instructions should the nurse include for the pt after a prostatectomy?
Avoid lifting objects heaver than 20 lbs for 6 weeks
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What is a common symptom of bladder cancer?
Hematuria
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What would the nurse expect to note on the stoma of a pt after a ureterostomy?
A red and moist stome
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Which nursing intervention would assist with preventing lymphedema after a radical masectomy?
Elevating the affected arm on a pillow above heart level
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What intervention is a priority in the plan of care for a pt who develops thrombocytopenia?
Monitor the client for bleeding
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What is a characteristic of multiple myeloma?
Malignant proliferation of plasma cells and tumors within the bone
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What would the nurse expect to note in the pt diagnosed with multiple myeloma?
Increased calcium level
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What is the process by which normal cells are transformed into cancer cells?
carcinogenesis
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What is a reduction in the number of circulating white blood cells due to depression of the bone marrow?
Leukopenia
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What is the term for uncontrolled or abnormal growth of cells?
neoplasm
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What is a reduction in the number of circulating platelets due to the suppression of the bone marrow?
thrombocytopenia
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What test, when elevated, can indicate that cancer has metastisised to the bone or liver?
Alkaline Phosphatase
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What lab value is increased for the pt with thyroid cancer?
serum calcitonin
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What is found in increased amounts in the pt with colorectal cancer?
CEA
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What can a chemo pt do to enhance the flavor of their food?
onion and ham will improve veggies; lemon juice can mask taste alterations
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What factors have been shown to have an impact on the determination of how well a pt will cope with a diagnosis of cancer?
Age at the time of diagnosis; availability of significant others; presence of symptoms
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How often should women in their twenties have a medical examination of their skin?
every 2 years
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What is the normal range for an INR?
2-3
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What is the normal lab value for PTT?
30-45
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What are the normal lab values for WBC?
5,000 - 10,000
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What are the normal lab values for platelets?
150,000 - 400,000
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What is the normal lab value for RBCs?
4.2-6.2
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What are the normal lab values for creatinine?
0.2-0.9
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What are the normal lab values for potassium?
3.5-5.0
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What are the normal lab values for calcium?
8.5-10.5
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