Finall Exam:l NSGl 434/l NSG434l (Latestl
2025/l 2026l Update)l Nursingl Carel ofl thel Childrearingl Familyl Completel Guide|l Questionsl &l Answers|l Gradel A|l 100%l Correctl (Verifiedl Solutions)-l GCU
Q:l managingl hematologicall andl immunologicall patients
Answer:
BLOODl TRANSFUSION -usel anl infusionl pump
-bel alertl forl transfusionl reactions:l keepl epil orl Benadryll onl handl
APHARESIS
-removel blood,l separatel components,l andl reinfusel -canl alsol removel andl savel plateletsl froml healthyl donors
Q:l cancerl inl pediatrics
Answer:
-mostl commonl underl 15:l leukemia
-mostl commonl overl 15:l brainl cancer
-survivall rate:l 85%
-liquidl cancer:l leukemial andl lymphomal
GENERALl SYMPTOMS
-flul like:l fever,l malaise,l pain
-weightl loss,l visionl loss -GIl distress -bonel fracturel wl bonel cancerl -lossl ofl energy TESTS
-bonel marrowl biopsy:l ofl iliacl crest
-spinall tap/lumbarl puncture:l tol seel ifl therel arel cancerl cellsl inl thel CSF *kidl isl sedatedl inl bothl ofl these -CBC,l LFT,l coagulationl studiesl
TREATMENT 1 / 4
1.l chemo:l combol ofl drugs
2.l radiation:l forl solidl tumorsl orl totall bodyl irradiationl forl liquid
3.l surgery:l tol remove
4.l multimodal 5.l biologicall responsel modifiers:l changel thel hostsl immunologicall mechanisms,l thel hostl cellsl nowl attackl cancerl cells 6.l bloodl orl bonel marrowl transplant:l goodl forl liquidl cancers.l usel chemol orl radiationl tol killl ofl bodiesl steml cellsl andl replacel withl newl healthyl onesl
7.l experimentall studies:l CAR-Tl celll therapy,l forl leukemial andl lymphoma
Q:l chemotherapy
Answer:
-isl al combinationl ofl specificl drugs -givenl throughl IVl access -givenl bel al highlyl trainedl andl certifiedl nurse >chemol isl veryl dangerous,l canl causel burnsl tol thel skinl immediately -patientl hasl al Chemol Protocoll Pathway:l everyl thel HCPl ordersl followsl thisl pathway.l itl tellsl thel days,l drugs,l doses,l anti-emetics,l IVl fluids,l labs,l diagnosticsl TYPES 1.l celll cyclel specific:l attacksl thel celll atl al certainl pointl ofl replication 2.l celll cyclel nonspecific:l addedl tol potentiatel thel effectsl ofl celll cyclel specific,l butl canl alsol attackl alll cells,l especiallyl bloodl steml cells
Q:l chemol andl radiationl SE
Answer:
KILLSl NORMALl CELLS
NAUSEA/VOMITING
-givel antiemeticl 30l minsl beforel andl forl 24l hoursl after -syntheticl cannaboidsl ALTEREDl NUTRITION -dailyl weights -I&Os -documentl dietaryl intake -offerl theml theirl preferredl meals
ALOPECIA
-bel honestl withl them,l knowl whatl chemol medsl causel it -startsl 2-3l weeksl afterl startingl chemo,l hairl growthl startsl 3-6l monthsl afterl chemol endsl MUCOSALl ULCERATION 2 / 4
-mouthl sores -givel soft,l moist,l blandl foods -softl spongedl toothl brush -magicl mouthwashl -nystatinl swishl andl swallow STEROIDl SIDEl EFFECTS -cushingoidl sidel effects:l puffyl face,l fluidl retention,l brittlel nailsl andl -Nal andl waterl restriction
ANEMIA
-bcl itl suppressesl bonel marrow -monitorl Hctl andl Hgb -givel PRBCl isl Hgbl goesl belowl 8
HEMORRHAGE
-chemol andl radiationl suppressesl platelets -closelyl monitorl plateletl levelsl -administerl plateletsl asl neededl NEUROGENICl ISSUES -jawl pain -footl drop -GIl problems
INFECTION
-numberl 1l adversel reaction -highl riskl ofl sepsis -monitorl ANCl tol determinel riskl forl sepsis
>ANC:l 10*WBC*(%l PMNl +l %l bands)
-neutropenia:l <1,500
-mildl neutropenia:l 1000-1500
-modl neutropenia:l 500-999
-severel neutropenia:l <500->highl riskl ofl sepsisl
*placel onl neutropenicl precautionsl whenl underl 500 -precautions:l onlyl cookedl foods,l fruitl withl thickl skin,l nol freshl flowers,l strictl handl hygiene,l ifl fever->broadl spectruml antibiotics
Q:l leukemia
Answer:
malignantl disorderl ofl thel bonel marrowl andl lymphaticl system -proliferationl ofl immaturel WBCl inl thel bonel marrow CELLl COUNTS
-inl ALL:l lowl leukocytel count
-highl levell ofl immaturel cells >theyl dontl attackl normall cellsl butl theyl competel forl metabolicl componentsl tol survive 3 / 4
>eventuallyl theyl suppressl thel bonel marrow->anemial (lowl RBC),l bleedingl (lowl platelets),l andl infectionl (neutropenia)
MANIFESTATIONS
-bleeding,l petechiae,l hemorrhage -infection,l fever -anemia,l pallor -bonel pain,l weakl bones->pronel tol fracture -anorexia,l fatiguel
DIAGNOSTICS
-Hx:l flul likel symptoms,l fever,l pain
-CBCD -bonel marrowl biopsy -lumbarl puncturel
MANAGEMENT
chemo
1.l induction:l strongl chemo,l 4-5l weeks
2.l maintenance:l 6l months
3.l consolidation:l tol preservel remission,l 2-3l yeasl
-donel inl patientl atl al dayl hospital,l admittedl inpatientl ifl theirl WBCl countl isl tool lowl bcl ofl thel chemo -theyl arel atl thel mostl riskl forl infectionl 7-10l daysl afterl chemol treatment,l calledl nadir -needl neutropenicl precautionsl ifl countl getsl tool low:l neutropenicl diet,l singlel doorl isolation,l dailyl cbcd,l doublel orl triplel antibiotics
**highl riskl ofl bacteriall skinl infection
Q:l hodgkinl lymphoma
Answer:
mostl commonl inl thosel 15-19 -cancerl originatingl inl thel lymphaticl systeml butl canl metastasizel tol thel liver,l lungs,l spleen,l andl bonel marrow
MANIFESTATIONS
-largel andl swollenl cervicall andl supraclavicularl lymphl nodesl >commonl inl neck,l armpit,l andl groinl -anorexia,l weightl loss,l abdominall discomfort,l nightl sweats,l cough,l fever
DIAGNOSE
-presencel ofl reed-Sternbergl cellsl inl al lymphl nodel biopsyl
TREATMENT
-radiation -chemo PROGNOSIS
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