1 MED SURG EXAM 2 | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+ what should you absolute neutrophil count be (ANC) Correct Answer: 1500 -1700 neutropenia Correct Answer: ANC <1500 moderate neutropenia Correct Answer: ANC 500 -999 severe neutropenia Correct Answer: ANC < 500 things to avoid if pt is neutropenic Correc t Answer: - fresh cut flowers (wilt, die, grow mold) - processed meats, undercooked meats (food bourne illness) chemo & radiation Correct Answer: cannot differentiate between good and bad cells so they kill them all - they both cause inflammation and death of WBC 2 Normal body temperature Correct Answer: 37.5 celsius, 99.5 fahrenheit Fever in an adult Correct Answer: 38.5 celsius, 101.3 fahrenheit Fever in neutropenic pt Correct Answer: 38 celsius, 100.4 fahrenheit Celsius to Fahrenheit formula Correct Answer: (Cx1.8)+32=F what is a complication of chemotherapy Correct Answer: tumor lysis syndrome Tumor Lysis Syndrome (TLS) Correct Answer: -oncologic emergency with rapid lysis of malignant cells -usually the result of chemotherapy or sometimes radiation -may occur 24 hours -7 days after antineoplastic therapy is initiated -develops when chemotherapy or irradiations causes the destruction of a large number of rapidly dividing malignant cells -intracellular contents are rapidly released into the bloodstream 3 Tumor Lysis Syndrome (TLS) part 2 Correct Answer: breakdown of tumor, cells are dying --> all their cellular contents are being released into the bloodstream --> increase in potassium (hyperkalemia), high uric acid (hyperuricemia) what should we monito r with TLS Correct Answer: BUN and creatnine TLS treatment Correct Answer: - rapid IV solution (isotonic), NS to flush this out of the body, keep them hydrated - give allopurinol prophylactically to prevent this from happening --> preventing conversion of uric acid complications of radiation Correct Answer: - esophagitis, skin irritation, N&V, anorexia, radiation pneumonitis - skin breakdown & inflammation Superior vena cava syndrome (SVC) Correct Answer: - Tumor can compress SV C and cause swelling of face, JVD, and visible chest veins 4 - something blocking blood from returning to the heart, could be a tumor, could be a prosthesis, PICC, etc. - upper trunk swelling, facial and arm swelling, flushing, redness - need to remove the tumor or shrink the size of the tumor --> can place cardiac stent - differentiate from anaphylaxis because it is localized! hematological malignancies Correct Answer: - disease of the bone marrow - RBC & WBC - in leukemia we have leukocytes - they are cancer cells - they push out all other cells like RBC and platelets - acute - if no tx they will die within a few months Acute Myeloid Leukemia (AML) Correct Answer: the most common form of leukemia in adults (50s -60s but can be anyone); develops when t he bone marrow produces too many myeloblasts AML symptoms Correct Answer: - fever - "B symptoms" - fatigue - malaise - drenching night sweats, - bleeding gums
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