PN3 final guide - exam
review
Professional Nursing III (Rasmussen
University)
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Professional Nursing III Final Exam Concept Guide
Information color coding
Exam 1—pinkExam 2—blueExam 3—purpleExam 4—peach
EXAM 1
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.
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● 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
EXAM 2
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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