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Nur-425

New Material - Final

TermDefinition
Malignant disease of bone marrow and lymphatic system Leukemia
What does decreased production of RBCs lead to with leukemia? Anemia
What does decreased WBC count (neutropenia) lead to with leukemia? Infection
What does decreased production of platelets lead to with leukemia? Bleeding tendencies
How is leukemia classified? Based on morphology
Which type of leukemia comprises 80% of all leukemias? ALL - Acute lymphoblastic leukemia
Which type of leukemia comprises 20% of all leukemias? AML - Acute myelogenous leukemia
Under what type of sedation is bone marrow aspiration done? Conscious sedation
What is the most common location for bone marrow biopsy on children? Iliac crest
What are the five (5) phases of treatment for leukemia? (1) Induction therapy, (2) Intensification or consolidation therapy, (3) CNS prophylactic therapy, (4) Maintenance therapy, and (5) Remission/relapse/prognosis
What is the goal of the induction therapy phase of leukemia treatment? Achieve remission or absence of leukemic cells
How long does the induction therapy phase of leukemia treatment last? 4-6 weeks
What three classes of medications are used in the combination therapy treatment of the induction phase of leukemia treatment? Corticosteriods, vincristine, and L-asparaginase
How would the three classes of medication in the induction phase of combination treatment of leukemia treatment be administered? Via central line access
What is the goal of the intensification/consolidation phase of leukemia therapy? To further decrease invasion of leukemic cells in CNS
What three medications are used in intrathecal (into spinal theca) chemotherapy in the CNS prophylactic phase of leukemia treatment? Methotrexate, cytarabine, and corticosteroids
What is the goal of the maintenance phase of leukemia treatment? To preserve remission
What percentage of children achieve remission from leukemia? 90 to 95%
How is the prognosis of leukemia determined? By staging
What percentage of children suffer from relapse from leukemia? 16%
What are side effects of long-term use of corticosteroids? Cushing syndrome - Moon face, buffalo hump, obesity in the trunk, mood swings
What are side effects of vincristine? Numbness, foot drop, N/V, bone marrow depression, alopecia
What are side effects of L-asparaginase? N/V, weight loss, and anorexia
When does hair generally return after leukemia treatment? 3-6 months
What immunizations need to be avoided when children are undergoing leukemia treatment? MMR and flu mist - live viruses - immunosuppressed, so don't want to introduce live viruses
What four interventions are not recommended to treat mouth ulcers? Lemon glycerin swabs, hydrogen peroxide, viscous lidocaine, and milk of magnesia
How many nurses (or trained personnel) need to double check the type/crossmatch of a patient before a blood transfusion? Two
Within how much time must the blood for a blood transfusion be hung? Within 30 minutes
Within how much time must the blood for a blood transfusion be administered? Within 4 hours
What is an autologous bone marrow transplant? Patient gives own bone marrow
What is an allogenic bone marrow transplant? Comes from donor
What are two possible sources of donated bone marrow? Peripheral blood stem cell (PBSC) and umbilical cord blood
What is the first sign of graft-vs-host disease (GVHD)? Skin rash
Which organs are most often affected by graft-vs-host disease? Skin, stomach, intestines, and liver
Prior to a bone marrow transplant, what does the patient undergo? Large doses of chemotherapy and total body irradiation
Based on what are suitable donors determined for bone marrow transplant? HLA matching - human leukocyte antigen
When is the right time to talk about palliative care? At the time of diagnosis
What sensations, thoughts, feelings are part of acute grief? Sensations of somatic distress, images of diseased, feelings of guilt and hostility, and loss of usual patterns of conduct
When does the process of mourning occur in regards to death? Mourning occurs well before the actual death
What are the four phases of mourning? (1) Shock and disbelief, (2) Expression of grief, (3) Disorganization and despair, and (4) Reorganization
Which is the last sense to go at the time of death? Hearing
What temperature sensation does someone who is dying feel? Sensation of heat but they're cool to the touch
What tool is used to assess children's percentage of body surface area affected? Lund and Browder
What percentage of total body surface area (TBSA) is classified as a minor burn? < 10%
What percentage of total body surface area (TBSA) is classified as a moderate burn? 10-20%
What percentage of total body surface area (TBSA) is classified as a major burn? > 20%
What type(s) of burns are described as partial thickness burns? Minor and moderate
What type(s) of burns are described as full thickness burns? Major
Describes a depth of burn that is partial thickness, affects the epidermis only, has erythema and pain, and heals by itself in 5-10 days Superficial (1st degree)
Describes a depth of burn that is partial thickness, looks wet and shiny, can have weeping, blisters, and edema, are very painful to touch and airflow/temperature changes, and take 3+ weeks to heal Partial thickness (2nd degree)
Describes a depth of burn that involves the epidermis, dermis, and subcutaneous tissue (nerve endings, hair follicles, sweat glands), can be red, waxy, brown and leathery, involves a lack of sensation Full thickness (3rd degree)
Describes a depth of burn that can impact bone and muscle 4th degree
Burn shock affects what system of the body? The circulatory system
Decreased cardiac output, increased fluid loss through burned skin, and increased capillary permeability describe what process after a burn injury? Burn shock
What is the life-threatening result of burn shock? Dramatic reduction of circulating blood volume
What is the best indicator of fluid status after a burn injury? Urine output
What is the priority intervention with burn injury treatment? Fluid resuscitation
Are enteral feedings contraindicated because of a paralytic ileus in a burn patient? No - need to keep gut moving to prevent translocation of gut bacteria that can cause infection
Describes a stress response to a severe burn that results in increased caloric needs of the body Hypermetabolism
Because of hypermetabolism, what will happen to a burn victim's body temperature? It will be elevated
What hormone is released as a result of the body's stress response? Cortisol
In the immediate care after a burn, what is the first step? Stop the burning process - stop, drop and roll; remove burning clothing, jewelry
What are the three (3) zones of injury in the local response to a burn? (1) coagulation, (2) stasis, and (3) hyperaemia
Where is the coagulaion zone of injury located? Closest to the injury
Describes a zone of injury where there is no capillary flow, no blood supply, and necrotic, dead tissue Coagulation zone
Describes a zone of injury where there is damaged tissue, decreased blood flow, and the tissue can be saved if perfusion is restored Stasis zone
Describes a zone of injury that is metabolically active, and has a normal, good response to tissue injury Hyperaemia zone
What nursing assessments are important in monitoring a circumferential burn? Pain, pallor, pulse, paresthesias, and paralysis
This can put someone at risk for the development of compartment syndrome Eschar
During this stage of burn care, ineffective airway clearance related to mucosal edema and deficient fluid volume related to increased capillary permeability are major concerns Acute stage
During this stage of burn care, risk for infection, impaired skin integrity, risk for ineffective thermoregulation, pain related to the burn injury, imbalanced nutrition, and impaired physical mobility are major concerns Management and rehabilitative stage
This burn treatment aids in debridement of wounds and cleansing, aids in range of motion, and helps loosen things to make debridement less painful Hydrotherapy
What medication is commonly used directly on wounds? Silvidine
This type of graft is taken from cadavers and is temporary (lasts 14 days) Allograft
This type of graft is taken from different species and is temporary (< 14 days to rejection) Zenograft
What is the ultimate goal in the long-term care of a burn survivor? Adapt to the burn injury and get them back into the community
Fruity breath, N/V, dehydration, ketones in blood/urine, mental confusion, electrolyte imbalance, dyspnea, and weight loss are signs/symptoms of this disease Diabetic ketoacidosis
To be classified as a diabetic, the patient would have this 8-hour fasting blood glucose level Greater than or equal to 126 mg/dL
To be classified as a diabetic, the patient would have this random blood glucose level Greater than or equal to 200 mg/dL
To be classified as a diabetic, the patient would have this OGTT (oral glucose tolerance test) level Greater than or equal to 200 mg/dL in 2-hour sample
Describes a type of insulin that has an onset of 15 minutes, a peak of 30-60 minutes, and a duration of 3-4 hours Rapid-acting insulin (clear)
Describes a type of insulin that has an onset of 30-60 minutes, a peak of 2-4 hours, and a duration of 5-7 hours Fast-acting insulin (clear)
Describes a type of insulin that has an onset of 1-2 hours, a peak of 4-12 hours, and a duration of 18-24 hours Intermediate insulin (cloudy)
Describes a type of insulin that has an onset of 3-4 hours, no peak, and a duration of 24+ hours Long-acting insulin (clear)
These tonsils are referred to as the adenoids Pharyngeal tonsils
These tonsils are the ones removed during a surgical procedure Palatine tonsils
Difficulty swallowing and breathing, mouth breathing that causes dry mucous membranes, mouth odor and impaired taste/smell describe signs and symptoms of this disease process Tonsilitis
This intervention can be used post-tonsilectomy, to treat pain Icepack around the neck for 24 hours
This is a sign, post-tonsilectomy, that can indicate narrowing of the airway Increased swallowing or difficulty swallowing
Post-tonsilectomy, this intervention facilitates drainage of secretions and decreases swelling Elevating the head of the bed 30 to 45 degrees
This can be used to increase visualization of the throat after a tonsilectomy Flashlight
Created by: ssbourbon