PN3 Final Study Guide DEEPLY ELABORATED
PN3 Final Study Guide DEEPLY ELABORATED
PN3 Final Study Guide DEEPLY ELABORATED
PN3 Final Study Guide DEEPLY ELABORATED
Know and understand about the complications of
chemotherapy
• Cognitive function=support and provide resources for cognitive
training. Let them know other patients report it too. Warn
against: excessive alcohol or drug use, head injury risks
• Mucositis=oral cryotherapy (rest of interventions listed below)
• Fatigue=space out and prioritize care
• Alopecia=teach how to avoid scalp injury; coordinate wig
purchases for patient based on income and lifestyle
• N/v=give antiemetic’s BEFORE hand, during, and after. Keep on a
schedule and educate patient to take them even when they feel
okay.
o Peppermint or ginger for relief
Know thrombocytopenia and what precautions are necessary
• Impaired clotting/bleeding; may require transfusion therapy
o Precautions: ensure a safe environment for the patient and
have bleeding precautions in place
-electric razor, soft bristled toothbrush, don’t
blow nose, no IM injections if possible, etc.…
Know about internal /external radiation / brachytherapy
Precautions for each
• Internal/brachytherapy
o The patient is a hazard
▪ Unsealed: enter body fluids and eliminated in waste
products, making the waste radioactive
▪ Solid implants are in one place, the patient emits
radiation but excreta is not radioactive.
• Precautions: wear dosimeter badge, keep front
,PN3 Final Study Guide
of lead apron facing patient, no pregnant
women or children under 16, visitors must stay
6 ft. away and limit visits to 30 min/day, never
touch radioactive source with bare hands (use
forceps), and save all dressings, bed linens
,PN3 Final Study Guide
until the radioactive source is removed; then
dispose as usual.
• External/teletherapy
o Radiation delivered from a source outside of the patient.
The source is external; therefore, the patient is not
radioactive, and there is no hazard to others.
Know basic labs such as CBC & Electrolytes, Pt, INR, and PTT
• CBC
o Hemoglobin: 13-17
o Hematocrit: 35%-48%
• Electrolytes
o K+: 3.5-5
o Na: 135-145
o Mag: 1.5-2.5
o Cal: 9-11
o Phosphorus: 2.5-4.5
• Clotting
o Pt: 11-13.5 seconds
o INR: 0.8-1.1
o PTT: 25-35 seconds
Know how to treat low hemoglobin
• Blood transfusion
Know the drugs to treat low hemoglobin and platelets when
getting chemo
• Hgb: Epoetin alfa—can prevent or improve anemia and reduce
the need for transfusions
• Platelets: Oprelvekin (neumega)—increases platelet production
by stimulating bone marrow (biologic response modifier)
Know what mucositis is and how to treat during chemo and
after chemo
• Mouth sores caused by chemo
o Tx—oral cryotherapy using ice chips before, during, or after
rapid infusions of agents (vasoconstriction)
▪ Sodium bi-carb rinses, frequent oral assessments and
hygiene
• Soft bristled toothbrush, gentle flossing, saline
rinse
,PN3 Final Study Guide
• IV injections of Palifermin—stimulates growth of
mucous membranes in the mouth
Know your burns
• Phases
o Resuscitation—onset 24/48 hours
o Acute—36/48 hours after—wound closure
o Rehabilitation—wound closure highest functioning
BSA % ------Rule of 9’s
How to differentiate each thickness
• Superficial=leaves a good blood supply, pink and moist;
blanches; painful
• Partial thickness=blisters occur
• Full thickness=eschar; not as painful
How to treat burns
• Monitor airway—assess by looking for drooling, trouble
handling secretions, brassy cough, wheezing, or diminished
breath sounds
• Assess fluid resuscitation—urine output 30 mL/hr.
• Assess for hypovolemic shock—monitor degree of edema
and cardiac status
• Assess for fluid shift hyponatremia and hyperkalemia
• Give fluids—LR
• Monitor electrolytes
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