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Professional Nursing III Final Exam Concept GuideInformation color coding
Exam 1—pink Exam 2—blue Exam 3—purple
Exam 4—peach
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
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
, 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
, IV injections of Palifermin—stimulates growth of
mucous membranes in the mouth
Know your burns
Phases
o Resuscitation—onset24/48 hours
o Acute—36/48 hours after—wound closure
o Rehabilitation—wound closurehighest 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
, Prevent infection (hand hygiene and standard precautions)
Drug management—morphine
Prevent gastric ulcers (curling’s)—H2 blockers, PPI’s
(pantoprazole)
Complications
Infection
Immobility contractures
Hypertrophic scarring
Interventions
Rapid fluid therapy, oxygen therapy, pain management,
antibiotic administration, CAM therapy, quiet environment,
wound care management
Know the Parkland Formula
4 mL LR X BSA% X body weight (kg)
o First half of solution over 8 hours
o Second half over 16 hours
Different types of triaging (Disaster & In hospital)
What’s your priorities?
The ranking system for each
TRIAGE UNDER USUAL CONDITIONS TRIAGE UNDER MASS CASUALTY
Emergent (immediate threat to life) Emergent—red tag
Urgent (major injuries that require Urgent—yellow tag
immediate treatment)
Non-urgent (minor injuries that do not Non-urgent—green tag
require immediate treatment)
Does not apply Expected to die—black tag
Understand stress debriefing after a mass casualty
The different types
Two general types of debriefing occur after a mass casualty
incident or disaster.
o The first type entails bringing in critical incident stress
debriefing (CISD) teams to provide sessions for small
groups of staff to promote effective coping strategies.
o The second type of debriefing involves an administrative
review of staff and system performance during the event to
determine whether opportunities for improvement in the
emergency management plan exist.
Know types of ventilators
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