You are caring for a patient who has just
received radiation therapy. Which of the
following teaching points will you include
in discharge teaching? (Select all that
apply):
•A.) Do not use anything on the skin that contains
perfume or alcohol.
•B.)Avoid extreme temperatures on the treatment field,
such as ice bags or heating pads.
•C.)Wear tigh-fitting clothing over the treatment field.
•D.) Wear lotion, like aloe gel, Aquaphor, or Biafine cream
to keep the area moist.
•E.)Use Ivory or Dove soap with tepid water when
cleansing the treatment field.
Which statement by the patient receiving
radiation therapy would the nurse need
to correct?
•A.)”I will not wipe off the markings around the treatment
field”.
•B.)”I can’t wait to go surfing with my friends this
weekend at the beach”.
•C.) “My radiation therapy will give me targeted therapy
to minimize collateral damage”.
•D.) “I will clean the treatment field frequently with mild
soap in a gentle patting motion and will pat it dry”.
A patient on chemotherapy and radiation for
head and neck cancer has a WBC count of 1,900,
a hemoglobin of 10.8 g/dL, and a platelet count of
99,000. Based on the CBC results, what is the
most serious clinical finding?
•A.) Cough, rhinitis, and sore throat
•B.)Fatigue, nausea, and skin redness at site of radiation
•C.)Temperature of 101.9 F, fatigue, and shortness of
breath
•D.)Skin redness at site of radiation, headache, and
constipation.
The nurse counsels the patient receiving
radiation therapy or chemotherapy that:
•A.)effective birth control methods should be used for the
rest of the patient’s life.
•B.)if nausea and vomiting occur during treatment, the
treatment plan will be modified
•C.)after successful treatment, a return to the person’s
previous functional level can be expected.
•D.)the cycle of fatigue-depression-fatigue that may
occur during treatment can be reduced by restricting
activity.
AML:CML:
•60-70 yr/olds…most are
elderly. Some children.
•Bowling AMF...The
elderly bowling together.
ALL:
•CHILDREN (before
14..between 2-9)
•FEVER
•Jesus loves the little
children, ALL the
children of the world!
•25-60…Peak age 45
•Certain Middle-aged Lads
•Asymptomatic early
on..develop symptoms
later.
•Can change to AML during
a blast crisis..can get old
and start liking to bowl.
CLL:
•50-70 men (old guys)
•Rarely seen before 30
years old.
This type of leukemia is characterized by
the proliferation of immature cells. They
become defective past the myeloblast or
the lymphoblast stage, so that the blood
does not have mature cells
•A.)Chronic
•B.)Acute
This disease is onset is more gradual
and involves more mature forms of
white blood cells (myelocytes):
•A.) Chronic Leukemia
•B.)Acute Leukemia
The most common type of leukemia in
older male adults is:
•A.)acute myelocytic leukemia
•B.)acute lymphocytic leukemia
•C.)chronic myelocytic leukemia
•D.)chronic lymphocytic leukemia.
Unclassified Leukemia: Mixed
Presentation
•Why is this type of leukemia difficult and why does
it usually produce a poor response from patients?
•Some chronic and some acute cells and some mixed in
between.
•Multiple morphologies of mutated cells.
•Problem: don’t know how to target with chemo. It
becomes a guessing game.
•Many trials…usually have to do chemo combined with total
body radiation.
H
•Reed-Sternberg cells
•Does not travel
outside of
system
•N 15-35
after 50
•M common men
•3 ASSOCIATING
FACTORS:
•------E Barr
V -------
•------G
P ----
•------E to
C T ---
•Prognosis usually great!
P will live 10
or later.
N -Hodgkin
•Multiple presentation
•D ’t repsond to
•M common…5
cau of canc
•EXTRA-NODAL SITES
•G them in remission
chemo a stem
transplant.
•Prognosis not as good.
H---HAPPY N----Not Happy
The nurse is aware that a major
difference between Hodgkin’s
lymphoma and non-Hodgkin’s
lymphoma is that:
•A.)Hodgkin’s lymphoma occurs only in young adults.
•B.)Hodgkin’s lymphoma is considered potentially
curable.
•C.)non-Hodgkin’s lymphoma can manifest in multiple
organs.
•D.) non-Hodgkin’s lymphoma is treated only with
radiation therapy.
True or False: Needle biopsy only
indicates that the site aspirated
does or does not have cancer cells:
•A.) True
•B.) False
A 70-year-old male patient has multiple
myeloma. His wife calls to report that he
sleeps most of the day, is confused when
awake, and complains of nausea and
constipation. Which complication of cancer
is this most likely caused by?
•A.)Hypercalcemia
•B.)Tumor lysis syndrome
•C.)Spinal cord compression
•D.)Superior vena cava syndrome
While helping a patient manage multiple
myeloma, which of the following actions
by the nurse would be incorrect?
•A.)Walk with them and encourage early physical therapy
and active and passive ROM
•B.)Maintain fracture precautions and encourage patient
to drink lots of fluid
•C.)Manage his pain with opiates and NSAIDS
•D.) Give calcium supplements to the patient with her
meals
