Card Set Information

2012-01-20 00:10:38
nclex adult health

saunders 4e
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  1. Findings indicative of multiple myeloma are an increased # of ______ cells in the bone marrow, anemia, hypercalcemia (electrolyte) caused by release of calcium from the deterorating bone tissue & increased BUN.

    What is one intervention to address both hypercalcemia and increased BUN?
    • 1. plasma
    • 2. Increase fluids in adequate amount to maintain good urine output. 3L intake/day to dilute the calcium and prevent protein from precipitating in renal tubes
  2. What are some clinical manifestations of ovarian cancer?
    • PAIN
    • Abdominal distention
    • Urinary frequency and urgency
    • Pleural effusion
    • Malnutrition

    From pressure caused by the growing tumor the effects of urinary or bowel obstruction, constipation, ascites with dyspnea and ultimately severe pain.
  3. Which of the followings is a complication after mastectomy?

    A. lymphedema
    B. sanguinous drainage
    C. c/o decreased sensation near operative side
    D. pain at incision site
    A. Lymphedema (arm edema) can ocur months or even years after surger

    All others are normal
    (this multiple choice question has been scrambled)
  4. Describe multiple myeloma and what do you expect to find in blood and urine?
    Proliferation of abnormal plasma cells -- destroy bones. Abnormal plasma cells produce abnormal antibody (myeloma protein aka Bence Jones protein found in blood and urine)

    • Cause decreased immunoglobulin &
    • Increased uric acid and calcium which can lead to renal failure
  5. S/S and interventions of multiple myeloma

    *hint: destroy bones
    • Bone pain, osteoporosis, spinal cord compression and paraplegia,
    • Bone marrow shows abnormal # of immature plasma cells. Thrombocytopenia, leukopenia, anemia
    • Renal failure d/t increased uric acid and calcium
    • Recurrent infxn

    • *Analgesics for pain
    • *Encourage plenty of fluid
    • *IV fluids & diuretics as prescribed to increase renal execretion of calcium
    • *Ambulation to prevent RF and slow bone resorption
    • *Bisphosphonate to slow bone damage & decrease pain and risk of fractures
    • *Monitor for bleeding, infxn, skeletal frx
  6. Testicular cancer almost always occurs in only 1 testicle & is usually pea-sized lump. Is it painful? Report to the physician
    No, it's not painful, but should be reported to the physician. Don't tell client to wait to see if it gets bigger the next month