oncology .docx

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RATIONALE: oxygen and IV access are immediate inter"entions for the client with cardiac

tamponade. Vasopressor agents will be administered to manage hypotension. Option #, a

pericardiocentesis is performed not a thoracentesis$ and radiation therapy in not indicated forcardiac tamponade

5. A !ient with aner who is reeiing ra"iation therapy "ee!ops thromboytopenia.The priority nursing goa! is to preent whih of the fo!!owing)

a. $ain re!ate" to spontaneous b!ee"ing episo"es.b. A!tere" nutrition re!ate" to anemia.

. 3n6ury re!ate" to the "erease" p!ate!et ount.

". 7-in brea-"own re!ate" to "erease" tissue perfusion.ANSWER: C.RATIONALE:This client is at high ris% for bleeding because of the decreased platelet count.

The priority nursing goal is to pre"ent inury to this client by pre"enting bleeding occurrences.

'pontaneous bleeding may cause pain but is not the priority. The client has a low platelet

count, but not a low hemoglobin count such as exists in anemia. '%in integrity is a ris% but nota priority.

8. A !ient who has been "iagnose" with !ung aner omp!ains of inreasing shortness of

breath an" "iffiu!ty swa!!owing. The !ient has faia! swe!!ing an" engorge" 6ugu!ar

eins. The nurse assesses the !ient for whih of the fo!!owing)

a. $u!monary embo!i.

b. Car"ia tampona"e.

. 7yn"rome of inappropriate seretion of anti"iureti syn"rome #73AD+&.". 7uperior ena aa syn"rome.

ANSWER: D.RATIONALE:'uperior "ena ca"a syndrome is a syndrome in which the superior "ena ca"a

is obstructed or compressed by tumor growth. 'igns and symptoms result from a bloc%age of

"enous blood flow from the head, nec%, and upper trun% and include difficulty breathing orswallowing, facial swelling, and ugular "enous distention. The other selections do not refer to

superior "ena ca"a syndrome.

. A !ient ha" a o!on resetion yester"ay. The !ient0s hemog!obin was 15.1 g:"!yester"ay an" to"ay0s hemog!obin !ee! is ./ g:"!. The !ient0s o'ygen saturation is


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which puts the client at great ris% for cardiac ischemia. The nurse administers oxygen

immediately.

The other inter"entions are appropriate, but not the priority at this time.

. 3t is an at where a thir" party, usua!!y imp!ie" to be a physiian, terminates the !ife of

a person either passie!y or atie!y)

a. ?uthanasia

b.me"ia! futi!ity.termina! se"ation

". ?n"@of@!ife.ANSWER: A

RATIONALE:euthanasia is an act where a third party, usually implied to be a physician,terminates the life of a person( either passi"ely or acti"ely. The modern concept of euthanasia

is based on the fact that patients ali"e who are li"ing in a situation that they consider to be

worse than death, are in a coma or are in a persistent "egetati"e state can be relie"ed from

their pain and misery


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RATIONALE: in the anger of ubler(*oss/s stages of dying, the indi"idual resists tne loss

and may stri%e out e"eryone and e"erything, in this case, the nurse.

1*. Contat of !ient on ra"iation therapy shou!" be !imite" on!y to how many minutes to

promote safety of the therapy personne!.

A. 1 minute

>. minutes

C. 8 minutesD. 1* minutes

Rationale: C.)rinciples of *adiation )rotection follows the 0T' system. 0istance 10, Time

1T, and 'hielding 1'. 0istance atleast 3 feet should be maintained when a nurse is notperforming any nursing procedures. Time limit contact to 4 minutes each time. 'hielding use

lead shield during contact.

11. 2hih of the fo!!owing is the reason to perform a spina! tap on a !ient new!y"iagnose" with !eu-emia)

A. To ru!e out meningitis

>. To "erease intrarania! pressure

C. To ai" in !assifiation of the !eu-emiaD. To assess for Centra! %erous 7ystem infitration

Rationale: D. 'pinal tap is performed to assess for -entral er"ous 'ystem infiltration. It

wouldn5t be done to decrease Intracranial pressure nor does it aid in the classification of theleu%emia. 'pinal tap can result in brain stem herniation in "ases of Intracranial pressure. #

spinal tap can be done to rule out minigitis but it isn5t indication for the test on a leu%emia

client.

1/. 2hen aring for a !ient with Centra! 4enous !ine, whih of the fo!!owing nursing

interentions shou!" be imp!emente" in the p!an of are for hemotherapya"ministration) 7e!et a!! app!y.

A. 3nspet the insertion site for swe!!ing, erythema, or "rainage

>. 4erifying pateny of the !ine by with presene of a b!oo" return at regu!ar intera!sC. A"minister ytoto'i agent to -eep a regimen on she"u!e een if b!oo" return is

not present.

D. 3f unab!e to aspirate b!oo", reposition the !ient an" enourage the !ient to ough?. Contat +e!th Care $roi"er about erifying p!aement if the status is (uestionab!e

Rationale: A, B, D, E.# maor concern with intra"enous administration of the cytotoxic agentis "essel irritation or extra"asation. The Oncology ursing 'oceity and hospital guidelines

re6uirefre6uent e"aluation of blood return when administarting "esicant or non"esicant

chemotherapy due to the ris% of extra"asation. There guidelines apply to peripheral and

central "enous lines. In addition, central "enous lines may be long term "enous access de"ices.


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Thus, difficulty drawing or aspirating blood may indicate the line is against the "essel wall or

may indicate the line has occlusion. 7a"ing a client coughor more position may indicate the

line has occlusion. Occlusion warrantes more thorough e"aluation "ia 8(ray study to "erifyplacement if the status is 6uestionable and may re6uire declotting rehimen.

oncology .docx

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