PN3 Final Study Guide
PN3 Final Study Guide
Professional Nursing III Final Exam Concept Guide
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
PN3 Final Study Guide
Professional Nursing III Final Exam Concept Guide
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
