PN3 Final Study Guide. | LATEST GUIDE

Professional Nursing III Final Exam Concept Guide Information 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—onset24/48 hours