Final Exam Study Guide
NUR 2790: Professional Nursing III
MODULE 1: CELLULAR REGULATION
Cancer
Primary vs. Secondary prevention
Primary CA prevention: removal of “at risk” tissue, chemoprevention, vaccination (HPV)
Secondary CA prevention: regular screening
Risk factors/warning signs (CAUTION mneumonic)
C: change in bowel/bladder function
A: a sore throat that does not heal
U: unusual bleeding
T: thickening lumps
I: indigestion/difficulty swallowing
O: obvious change in mole
N: nagging cough/hoarseness
Treatment types, side effects/complications (& treatment/nursing care of side
effects/complications)
Surgery: can be prophylactic, diagnostic, curative, palliative
SE/complications: removed organs and tissues lose function, removal of organs does
not necessarily rid cancer
Radiation: destroy cancer cells with minimal damaging effects of surrounding normal
cells
SE/complications: radiation dermatitis, altered taste/fatigue, atherosclerosis,
coronary artery disease, fibrosis, scarring, bone marrow suppression
Nursing care: provide accurate info, skin care (wash gently with soap and water,
avoid scrubbing), do not remove temporary ink markings, provide nutritional
support, care of xerostomia (administer saliva substitutes, lozenges, mouth rinses),
reduce risk for bone fracture, encourage exercise and sleep interventions to treat
fatigue
Chemotherapy: treatment of cancer using antineoplastic drugs (cytotoxic systemic
therapy)
SE/complications: dosage and scheduling (dose-limiting side effects may impact),
extravasation and vesicants, bone marrow suppression (neutropenia, anemia,
thrombocytopenia), mucositis (inflammation of oral mucosa) alopecia (hair loss),
chemo brain, chemo-induced peripheral neuropathy, fatigue
Nursing care: epo-alfa/Epogen, blood products, no flossing, soft toothbrush, no
razors, no NSAIDS, treat nausea (peppermint oil, Zofran, fluids, room temperature
food, alcohol swabs)
Immunotherapy: enhances and alters pt’s biological response to cancer cells via
direct antitumor activity
SE/complications: fluid shifts/inflammation, decreased LOC and other neuro
changes, fever, chills, malaise
Photodynamic therapy: selective destruction of cancer cells via chemical reaction
triggered by last light which destroys or shrinks tumors
Hormonal manipulation: changing usual hormone responses to slow tumor growth to
certain cancer types
SE/complications: masculinizing affects in women, feminizing effects in women
(gynecomastia), fluid retention, acne, hypercalcemia, liver dysfunction, VTE
Bone marrow transplants: transplant of bone marrow from a matched individual (self
or other)
SE/complications: nausea, vomiting, graft vs. host disease, infection, organ damage
,Complementary & Alternative Medicine (CAM)
Types of CAM (mind-body therapy, tai chi, chiropractic care, herbal meds, etc.), goals of
use, and interactions
Mind-body therapies: biofeedback, guided imagery, intercessory prayer, meditation,
relaxation exercise
Biologically-based therapies: herbal therapies (chamomile, garlic, gingko, ginseng,
peppermint, st.john’s wart, vaerin)
Manipulative and body-based therapies: acupuncture, acupressure, chiropractic,
massage, rolfing, shiatsu, tai chi, yoga
Energy therapies: reiki, therapeutic touch
Alternative medical systems: homeopathy (tx of disease with minute drug doses to
activate and illness that then stimulates the body’s normal defense system to eliminate
disease; remedies without chemically active ingredients), naturopathy (the practice of
assisting in the health of patients through the application of natural remedies),
osteopathy (embracing the full spectrum of medicine, including the use of medications
and surgery, in addition to manipulative techniques)
MODULE 2: END-OF-LIFE CARE
Chapter 10: Principles of Emergency and Disaster Preparedness
Palliative vs. Hospice care (goals of each, differientation)
Palliative care: can be any stage of serious or chronic illness, care may be provided
concurrently with curative therapies, care not limited by time periods, care provided by
PCP with potential follow-up vistis
Hospice care: prognosis of less than 6 months to live, initiated when curative tx stops,
60-90 day periods of care, care provided by RNs, social workers, chaplains, and
volunteers
Ethical/legal considerations r/t dying (AD’s, living will, euthanasia, etc.)
Durable power of attorney for health care (DPOAHC): makes decisions about pt’s
healthcare when MD determines pt does not have capacity to make decisions (pt
does not receive info, pt does not evaluate, deliberate and mentally
manipulate info, pt does not communicate a tx preference)
Living will: discusses CPR or code status (must be initiated unless and DNR order
exists, may be violent and painful), intubation/artificial ventilation, artificial
nutrition/hydration
“Five wishes”: identification of decision maker (DPOAHC), identification of
treatments the pt does/does not want, comfort level expectations, how they
want to be treated, what the pt wants loved ones to know
Active euthanasia: use of medications or tx that purposefully causes pt’s death
(physician assisted suicide)
Passive euthanasia: discontinuation of one or more therapies that may prolong life
Voluntary stopping of eating and drinking (VSED): refusal to eat or drink in order to
hasten death by competent pt with terminal illness
S/Sx of end-of-life
Lack of heartbeat, absence of spontaneous respirations, irreversible brain
dysfunction
Weakness, anorexia, changes in cardio function (cool, mottled cyanotic extremities,
decreased BP, heart rate will increase-irregular-brady-asystole), dyspnea (cheyne-
stokes), changes in GU (incontinence, decreased UO), changes in LOC (sleeping,
restless, anxiety, lethargy)
MODULE 3: TISSUE INTEGRITY
Chapter 10: Principles of Emergency and Disaster Preparedness
, Traditional triage vs. Mass Casualty triage
Traditional triage: most critical pt’s are seen first(emergent/immediate threat to
lfie, urgent/major injuries, nonurgent minor injuries)
Mass casualty triage: emergent (red tag) pt’s seen first, urgent (yellow tag), nonurgent
(green tag), expectant or allowed to die (black tag)
Internal vs. External events
Internal events: power outage, active shooter, explosion
External: tornado, volcano, hurricane, wild fires, epidemics
Chapter 26: Care of the Patient with Burns
Classifications of burn injury (superficial, partial-thickness, etc.)
Superficial-thickness burns (1st degree): least damage; epidermis is only part of skin
injured (sun burn, flash exposures)
Partial-thickness burns (2nd degree):
Superficial partial-thickness: injury to upper third of dermis, pink moist blanchable,
blister formation, heals within 10-21 days without scarring
Deep partial-thickness: extend deep into the dermis, red dry with slow blanching,
no blisters, edema, heal within 2-6 weeks with scarring
Full-thickness burns (3rd degree): destruction of entire epidermis and dermis, skin does
not regrow, characterized by; eschar, edema, waxy-white, deep-red, yellow, brown, or
black appearance, may have no blood supply, reduced/absent sensation, healing takes
weeks to months
Rule of 9’s
Phases of burn injury (time periods, priority assessments, etc.)
Resuscitative/emergent phase: 24 to 48 hours
Goals: secure airway, support circulation (fluids), pain relief, prevent infection,
maintain body temp, provide emotional support
Assessment: direct airway injury (hoarseness, brassy cough, drool, tachypnea,
wheezes, stridor), smoke poisoning, pulmonary edema (SOB, crackles), CO
poisoning (cherry-red coloring, headache, nausea, drowsiness, irritiable), thermal
airway injury (ulcerations, redness, edema), hypovolemia, decreased CO, decreased
BP with increased HR, EKG changes with direct heart damage, fluid shifts, decreased
UO, concentrated urine
Diagnostics: increased Hgb, Hct, increased BUN, glucose, potassium, decreased
sodium, protein and albumin
Interventions: maintain airway, fluid resuscitation, manage pain, preventresp
distress
Acute phase: 36-48 hours
