Radiation Oncology
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| What is myelosupression? | A reduction in bone marrow function which causes pain in patients
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| Myelosuppression can cause what blood conditions? | Anemia, leukopenia, and thrombocytopenia
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| What is anemia? | A decrease in the peripheral red blood cell count.
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| What is leukopenia? | A decrease in the white blood cell count
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| What is thrombocytopenia? | A reduction in the number of circulating platelets.
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| What is the average WBC? | 5,000 – 10,000 /mm3
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| What is the average platelet count? | 200,000 – 500,000 /mm3
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| What is the average RBC? | Males: 5 * 106 /mm3
Females: 4.5 * 106 /mm3
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| Side effects associated with radiation treatment to the skin | Erythema, dry desquamation, and moist desquamation
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| After how much dose would you expect to see erythema? | 30-40 Gy
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| After how much dose would you expect to see moist or dry desquamation? | 40-60 Gy
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| What can be given to patients when their skin becomes sensitive and begins to itch? | Aquaphor or something similar
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| Side effects associated with radiation treatment to the head and neck | Alopecia, dysphagia, xerostomia, mucositis, taste change, esophagitis, skin reactions (ex. erythema), and dry eye
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| What can be given to patients when they develop mucositis or esophagitis? | Magic mouthwash which includes Maalox, Benadryl, and Lidocaine
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| After how much dose would you expect to see alopecia? | 20 Gy
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| After how much dose would you expect to see mouth changes such as xerostomia, stomatitis, mucositis, or taste change? | 20-30 Gy
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| After how much dose would you expect to see esophagitis? | 20-30 Gy
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| Side effects associated with radiation treatment to the chest | Dysphagia, esophagitis, nausea, pneumonitis, fibrosis, and fatigue
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| After how much dose would you expect to see nausea and vomiting? | 10-20 Gy
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| What might be prescribed for nausea and vomiting? | Zofran
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| Side effects associated with radiation treatment to the abdomen | Diarrhea, abdominal cramps, vomiting, fatique, and nausea
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| After how much dose would you expect to see diarrhea? | 20-50 Gy
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| What can be taken for diarrhea? | Immodium
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| Side effects associated with radiation treatment to the pelvis | Diarrhea, proctitis, dysuria, fatique, and cystitis
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| After how much dose would you expect to see cystitis? | 30-40 Gy
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| What can be given for dysuria? | Flomax
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| What can be given for cystitis? | Pyridium
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| What is the difference between a drug and medication? | A drug is any substance that alters physical function whereas a medication is administered with a therapeutic intent
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| Six Rights of Drug Safety | Right patient
Right medication
Right dose
Right time
Right route
Right documentation of delivery
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| Proper Response to an Allergic Reaction to Contrast | Immediately stop procedure
Call oncologist
Stay with patient
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| Types of emergencies most likely encountered | Asthma attack, pulmonary edema, anaphylactic shock, and cardiac arrest
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| Routes of Drug Administration | Oral, mucous membrane (ex. sublingual), topical, and parenteral
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| Common Parenteral Routes | Intradermal, subcutaneous, intramuscular, and intravenous
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| Purpose of Contrast Media | Increase visibility of soft tissue and internal structures with low natural contrast
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| Two Basic Types of Contrast Agents | Radiolucent (negative)
Radiopaque (positive)
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| Examples of Radiolucent Contrast Agents | Air and Carbon dioxide
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| Ionic Contrast | Ions (charged particles) are created when the agent dissolves in the blood
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| Nonionic Contrast | Do not dissolve into ions when they enter the blood
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| Osmolality | Indicates the number of particles in a given solution of water
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| All Ionic Contrast Agents have ____ Osmolality | High
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| Most Nonionic Contrast Agents have ____ Osmolality | Low
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| Potential Reactions to Contrast | Hypovolemia, kidney toxicity, and allergic reactions
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| What is an idiosyncratic response? | Unpredictable response
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| What is a non-idiosyncratic response? | Predictable response, what you can expect
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| What is extravasation? | Leakage of fluid into the tissues
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| What is the preferred contrast agent for imaging of the GI system? | Barium sulfate
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| What are routes of administration for barium sulfate? | Oral and rectal
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| What is a normal blood pressure range? | 120/80 mmHg or below
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| What are different ways to check one’s temperature? | Oral, rectal, and axillary
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| What temperature is average when taken orally? | 98.6° F
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| What temperature is average when taken rectally? | 99.6° F
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| What temperature is average when taken axillary? | 97.6° F
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| What is the normal pulse rate range for adults? | 60 to 90 beats/min
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| What is the average rate of respiration for adults? | 10 to 20 breaths/min
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| What is the study of the distribution and determinants of diseases and injuries in human populations? | Epidemiology
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| What is the presence of an agent that is infectious but does not initiate an immune response? | Colonization
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| A person who carries a specific pathogen but is free of signs or symptoms of the disease and yet is capable of spreading the disease is referred to as what? | Carrier
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| The term used when an infection is acquired in a hospital? | Nosocomial
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| What are five different routes of transmission? | Contact
Droplet
Common vehicle
Airborne
Vectorborne
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| What transmission route is the cause of most nosocomial infections? | Contact
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| How does droplet transmission occur? | Involves the rapid transfer of the infectious agent through the air over short distances
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| What are causes of droplet transmission? | Talking, coughing, sneezing, etc.
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| How are droplet contact and airborne transmission differentiated? | By particle size and distance
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| Should a needle be recapped after use? | Never recap a needle
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| Where do used needle go? | They are discarded in a sharps container
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| Needlesticks account for what percentage of job-related acquired HIV? | 84%
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| Can a paint pen be used on different patients? | A pen used to apply marks on a patient’s skin should never be used on multiple patients.
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| When should gloves be worn? | Gloves should be worn when touching blood, body fluids, secretions, excretions, and any contaminated items.
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| When should hands be washed? | Wash hands immediately after gloves are removed, between patients, and when otherwise indicated to prevent the spread of microorganisms
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| What is the single most effective weapon for reducing nosocomial infection? | Hand hygiene
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| How should fingernails be maintained for healthcare workers? | Fingernails should be natural, unpolished, short, and neat.
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| Why is it important to remove gloves after positioning patient but before using equipment? | To avoid the spread of disease
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| Examples of Radiopaque Contrast Agents | Barium and Iodine
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