Faisal’s Reviewer

ii. Time allowed is THIRTY minutes

Oncology iii. Shielding of LEAD apron and dosimeter
badge
1. Cancer is an abnormal cell growth
iv. Distance of SIX FEET
2. Theories:
v. If sealed
a. Cellular Transformation – CARCINOGENS
01. CBR without BP to prevent
b. Failure of Immune Response –
dislodgement
Immunodeficiency = Cancer
02. Indwelling catheter
3. TNM: Tumor Node Metastasis
03. Cleansing Enema
4. Warning Signs of Cancer – CAUTION US
04. LOW RESIDUE DIET to promote
a. Change in bowel or bladder habits
constipation
b. Any sore that does not heal
05. Ready at the bed side: Long handled
c. Unusual Bleeding
forceps and lead container
d. Thickening of lump of breast or elsewhere
06. If unseen: GO OUT, INFORM MD,
e. Indigestion
RADIOACTIVE TEAM
f. Obvious change in wart or mole
9. NADIR: Period of greatest bone marrow depression
g. Nausea and Vomiting
a. Nursing Responsibilities:
h. Unexplained Anemia
i. Check CBC
i. Sudden Weight Loss
ii. If Absolute neutrophil count goes below
5. Test Taking Strategy (TTS) on radiation: ALWAYS
1000 cells/mm3, STOP
CHECK THE TYPE OF THERAPY BEFORE
CHEMO/RADIATION
ANYTHING ELSE
10. Chemotherapy
6. General Radiation Responsibilities:
a. No RAW THINGS
a. Assess and manage complications WITH the
b. No live immunization: MMR Polio, Varicella,
rad-onco
flu
b. Assist in documenting results of therapy
c. Provide SOFT foods that are cool to warm
c. Provide emotional support
(NOT hot nor cold)
7. External Radiation/ Tel-E-therapy: MARKED
d. Phases:
AREA for radiation
i. Induction Therapy: Rapid complete
a. Nursing Responsibilities: CALMS
remission of all s/sx
i. CBC check
ii. Consolidation: Aim is CURE
ii. Assess Lungs
iii. Maintenance: MAINTAIN REMISSION
iii. Medication checking
11. Hodgkins Disease:
iv. Skin Changes
a. (+) Reed-Sternberg Cells
b. Client Teaching:
b. (+) CT Scan of liver and spleen
i. NO SOAP, only water for washing
c. Maintain infection and bleeding precautions
ii. ELECTRIC RAZOR for shaving affected
12. Multiple Myeloma:
area
a. Malignant B-cells go to bone marrow
iii. No heat or cold
b. PAIN is primary concern
iv. No lotion unless prescribed
c. (+) Bence-Jones Proteinuria (IG in urine)
v. Loose, soft clothing
d. (+) Pathological fractures
vi. No sun s/t PHOTOSENSITIVITY
e. >2L OFI
vii. SPF 15
f. Give BISPHOSPHONATE meds to slowbone
viii. No risk for radiation exposure
damage
ix. Rest
13. Testicular Cancer:
x. High protein diet, SFF
a. Early Detection: TSE
8. Internal Radiation/ Brach-I-therapy: IMPLANT
i. Right after a warm shower, first day of the
a. TTS: Check if SEALED or UNSEALED before
month
anything else
b. (+) Painless testicular swelling
b. Nursing Responsibilities: PTSD
c. (+) Dragging/pulling sensation
i. Private Room
d. Gynecomastia may indicate metastasis
01. Private CR
e. Late signs include pelvic to lower extremity
02. AWAY from nurse’s station
pain
03. Flush toilet TWO-THREE times

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14. Cervical Cancer: iii. Colostomy:
a. Screening: PAP smear or Vaginal inspection 01. If no pouch system, apply a petroleum
with Acetic Acid (VIA) jelly gauze over stoma to keep moist
b. Therapy: Conization covered with dry sterile dressing
i. Cone area removed 02. Pouch system: Colostomy Appliance
ii. Okay to have babies  Colobag
iii. May cause premature rupture of  Colostomy wafer (Adhesive tape
membranes around the stoma)
c. No tub baths  Empty the pouch when 1/3 full to
d. Limit stair climbing for 1 month facilitate peristalsis
e. No sex for 3-6 weeks 18. Lung Cancer
f. If hysterectomy is done, >1 saturated pad per a. Place in fowler’s position
hour is EXCESSIVE bleeding b. Provide O2
g. Pelvic Exenteration: Removal of ALL pelvic c. Closed chest drainage NOT used in
content pneumonectomy
i. Administer prophylactic heparin 19. Prostate Cancer:
ii. Sex is not possible after (Sarado pekpek) a. (+) Hard pea-sized nodule on DRE
15. Endometrial Cancer b. LH is given to slow tumor
a. Abnormal Bleeding c. TURP
b. Tamoxifen is used i. WOF: TURP Syndrome
c. THBSO if surgery 01. Fluid Overload
16. Breast CA 02. Isoosmolar hyponatremia
a. Early Detection: BSE (7-10 days after menses, 03. Absorption of fluid during bladder
after warm shower) irrigation
b. Surgery: Mastectomy d. Increase OFI
i. Semi-fowler’s e. Bright red urine: Arterial bleeding
ii. Unaffected side f. Burgundy-colored: Venous
iii. ELEVATE ARM to prevent lymphedema g. Red to light pink for 24 hours
iv. SAVE THE ARM on the side of h. Amber in 3 days
mastectomy i. AVOID ATTEMPTS TO VOID
c. Give emollient in incision care to prevent j. Maintain traction of 3-way catheter
contractures 20. Bladder Cancer:
17. Colon CA a. Ileal conduit may be done after cystectomy
a. Hematochezia/ melena b. The Kock pouch is a continent internal ileal
b. Early sign: reservoir
i. Increased peristalsis c. Measure pH of urine
c. Late signs: d. DO NOT PUT THE DIPSTICK INSIDE THE
i. Abdominal guarding STOMA UTANG NA LOOB
ii. Cachexia 21. Tumor Lysis Syndrome:
d. Colostomy may be done after colectomy a. Hyperkalemia
i. Other term: Fecal Diversion b. AKI
ii. Ileostomy: c. Give Allopurinol
01. Post-op drainage: dark green – yellow 22. Onco Meds
02. Liquid a. General Interventions:
03. Immediate NDx: Disturbed body ii. Bleeding precautions
image iii. High valorize, High CHON
04. Later NDx: F/E deficit iv. Monitor for extravasation and REPORT
05. Monitor stoma in color IMMEDIATELY TO HCP
 Red/Pinkish: Normal v. Teach about contraception s/t teratogenic
 Pale pink: Low HCT/ HGB effects
 Yellowish: (+) Pus vi. Wig BEFORE treatment
 Brown/Rusty: Ischemia vii. NO LIVE VACCINES (MMR, Polio,
 Black/Blue/Purple: Necrosis Varicella, flu)
viii. Monitor anaphylaxis

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ix. DO NOT REMOVE IV LINE IN CASE
OF EXTRAVASATION Positioning Clients
x. Alkylating:
1. Elevate HOB:
01. ABC3 (Alkylating Busulfan,
a. Facial burns
chlorambucil, cisplatin,
b. GERD
cyclophosphamide)
c. Hypophysectomy
02. Hemorrhagic Cystitis
d. Autonomic Dysrefflexia
03. Increase OFI by 2-3 L
e. Cerebral Aneurysm
04. Do NOT give with food
f. Stroke
xi. S Phase (FAMAS)
g. Craniotomy
01. Fluorouracil (Colon)
h. Increased ICP
02. Anti-metabolite
i. PRIOR to thoracentesis
03. Methotrexate
j. Cardiac Catheterization
 May decrease Folic Acid
 Anemia from Folic Acid 2. Elevate Affected:
 Give Leucovorin (Leucovorin a. Circumferential Burns
Rescue) b. Skin Graft
04. S Phase c. Mastectomy (arm)
xii. Anti-tumor Medications d. Amputation
01. Rubicin e. Venous Insufficiency
02. Cardiotoxic 3. Semi-Fowler”s
xiii. Vinca Alkaloids a. Mastectomy
01. Vin- b. Thyroidectomy
02. Peripheral neuritis c. Feedings
xiv. Immunomodulator d. Laryngectomy
01. Interleukin: Recognize and destroy 4. High Fowler’s
abnormal cells a. Insertion of NGT
02. Interferon: Cancer cell differentiation b. Dyspnea
to normal cells 5. Side lying
a. Hemorrhoidectomy
b. After Liver biopsy (right)
c. Rectal enema (sims)
d. 3rd trimester preggy (left)
6. Supine
a. Lumbar puncture
b. During liver biopsy
7. On Affected side
a. Pneumonectomy
b. Pleurodesis
c. *All others, unaffected

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Cataract: Retinal Detachment:

1. Opacity of lens 1. Separation of retina from the choroid
2. Build-up of sorbitol 2. (+) floaters, curtain sensation, flashes of light
3. EARLY 3. Bed rest
a. Blurred vision 4. Cover both eyes as prescribed to prevent further
b. Decreased color perception detachment
4. LATE SIGNS 5. Speak beforte approaching
a. Diplopia 6. Avoid jerky head movements
b. Reduced visual acuity 7. Surgery: Scleral buckling
c. Absence of red reflex 8. Limit reading for 3-5 weeks
d. White pupil 9. POSSIBLE RECURRENCE
e. Pain, redness (if age-related)
5. Most common eye disorder among filipijnos
6. Surgery: Intracapsular extraction Macular Degeneration:
7. Position: elevate HOB by 30-45 degrees
1. Deterioration of the macula
8. Turn on NONOPERATED side
2. LOSS OF CENTRAL VISION
9. Orient client
3. Types:
10. Avoid rubbing and lifting heavy objectsz
a. Atrophic (dry; age-related)
11. SAFETY IS THE PRIORITY
b. Exudative (Wet)
4. Therapy:

Glaucoma a. Laser Therapy

b. Photodynamic Therapy: Verteporfin Dye
1. Increased intraocular pressure i. Activated by nonthermal red light in the
2. Types: presence of oxygen
a. Open angle ii. NO to sunlight on eyes but OK in other
i. Obstruction in the flow of aqueous humor parts to facilitate inactivation
(MAY BARA) iii. Common S/E: HEADACHE, visual
ii. Painless, tunnel-vision disturbances
iii. MIOTICS iv. No to concurrent administration with CCB
iv. Beta-blockers (Increase levels)
b. Angle-closure v. Assess for EXTRAVASATION
i. Block flow of aqueous humor (WALANG  Largest arm vein
BUTAS) vi. Solution is dark green opaque
ii. Halos
iii. Ocular erythema
iv. EMERGENCY
v. Surgery: Trabeculectomy
c. Early:
i. DIMINISHED ACCOMMODATION
ii. Increased IOP

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b. Demonstrate understanding of the drug’s
Endometriosis therapeutic effects
c. Take medication exactly as ordered
1. Pelvic tenderness upon palpation of the cervix
d. TTS: When answering objectives or outcome
2. Small masses palpable upon abdominal examination
questions, always refer to the VERB first.
3. NDX: CHRONIC PAIN r/t endometrial pelvic
Check if it complies with bloom’s taxonomy
implants
(scan through this). Words such as report,
4. Anxiety
adhere, develop, demonstrate, discuss,
5. Defficient knowledge
verbalize, explain are examples of appropriate
6. Ineffective sexuality patterns
verbs used in outcomes or objectives.
7. Objectives:
5. Interventions
a. Demonstrate effective SELF-CARE
a. Monitor development of breast tumors
MEASURES to deal with the pain
b. Monitor thrombophlebitis
b. Verbalize decreased anxiety
c. NO SMOKING
c. Demonstrate understanding of disease and
d. NO SMOKING
treatment
e. NO SMOKING
d. Verbalize improvement of sexual function
f. NO SMOKING
8. Implementation:
g. NO SMOKING
a. Identify type, location, duration, history of pain
h. Monitor blood and urine glucose
b. Recommend analgesics as ordered and heat
i. Encourage compliance
therapy
6. Client Teaching:
c. Discuss causes of endometriosis
a. Report familial history ofCV or estrogen-
d. EVOF
dependent tumor
COCs b. SBE
c. Report signs of thrombosis
1. Assessment d. Report cardiac problems
a. Health history including CIGARETTE e. Monitor BP
SMOKING f. Join SMOKING CESSATION PROGRAM
b. Health history including CIGARETTE g. Join SMOKING CESSATION PROGRAM
SMOKING h. Join SMOKING CESSATION PROGRAM
c. Health history including CIGARETTE i. Join SMOKING CESSATION PROGRAM
SMOKING j. Join SMOKING CESSATION PROGRAM
d. Health history including CIGARETTE k. Join SMOKING CESSATION PROGRAM
SMOKING l. Amenorrhea with vaginal spotting is normal
e. CV status
f. Pregnant or lactating
g. Rationale:
i. Oral contraceptives (especially estrogen)
increases blood viscosity thus increasing
BP
ii. Hormonal effects on the preggy and
lactating may alter normal reproductive
functioning
2. NDx:
a. Deficient Knowledge
b. Nausea
c. Noncompliance
3. Goal:
a. The couple will have properly spaced and
planned pregnancies (the use of contraceptives
is the decision of the couple NOT only of a
single person)
4. Objectives:
a. Report effective birth control

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Spiritual Nursing Chronic Fatigue

1. Assessment:
a. Always remain respectful and non-biased Syndrome
b. HOPE Tool:
1. The severity of the CFs and how it affects people
i. Hope sources
varies from person to person.
ii. Organized religion membership
2. There is limited work, school, and family activities
iii. Personal spirituality
3. Cause is unknown
iv. Effects of spirituality and beliefs on
4. It may be rooted from infectious agents, led by the
medical care and end-of-life issues
EBV
v. Spirituality is different from religion in that
5. Women > Men
spirituality is the personal belief in God of
6. Immune dysfunction syndrome
the person while religion is the traditions,
7. S/Sx
rules, cultural expectations in relation to
a. More than 6 months
belief in God.
b. Short term memory loss
vi. Always begin assessment by asking “For
c. Severe inability to concentrate
many people, religion and spiritual beliefs
d. Sore throat
can be a source of comfort and peace
e. Swollen lymph nodes in the neck or armpits
during hard times. Is this true for you?”
f. Muscle and joint pains
2. Interventions:
8. NDx: Fatigue
a. Three Key Interventions:
9. Basis for evaluating outcomes of care: Mutual
i. Improve or facilitate process of
planning with the patient and family
communication between patient and people
10. Interventions:
or patient and Higher Being
a. Co-morbid psychiatric conditions should be
 Active Listening
identified and treated
 Therapeutic Touch b. Gradually build up activities
 Building Trust c. Prepare the client for the fact that there will be
 Being Present setbacks and relapses
ii. Assist process of doing spiritual and d. Self-help materials may be helpful
religious activities e. Lifestyle factors should be addressed
 Prayer f. NO SMOKING
 Meditation g. NO SMOKING
 Arranging for ritualistic needs (e.g. h. NO SMOKING
dietary considerations) i. NO SMOKING
 Connecting to hospital chaplain j. NO SMOKING
services or other religious heads k. NO SMOKING
iii. Physical Care l. Develop a work plan
 Physical needs must be met,
ESPECIALLY PAIN
3. Barrier to Spiritual Care:
a. Lack of inclusion in nursing education is the
MAIN barrier

4. Parish Nursing
a. An RN with a minimum if TWO year
experience working in the faith community to
address health issues of its members as well as
those in the broader community or
neighborhood (International Parish Nurse
Resource Center, 2011)

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c. Participate as proactive key player in
Hypochondriasis collaborations
d. Tackling multiple health determinants
1. Preoccupation with fears of having a serious illness
e. Evaluating health promotion activities
2. No evidence of physical illness exists
f. Generating new knowledge by research
3. Extensive use of home remedies or nonprescription
g. Advocate for the patient
medications
4. Repeatedly visiting a health care provider DESPITE
repeated reassurance and normal test results
Pilocarpine
5. Secondary gain 1. May be administered intramucosally or orally
2. If oral: management of xerostomia s/t cancer
Health Promotion radiation
a. S/E: Think PNS
1. Competencies of a nurse:
b. Avoid driving
a. Multidisciplinary Knowledge
c. Increase OFI
i. Knowledge
3. If miotic:
ii. Ability to implement
a. For IOP reduction
iii. Be aware of cultural aspects of health and
b. Upon application, apply gentle digital pressure
Health economics
to periphery of nasolacrimal drainage system for
b. Skill-related competence
1-2 minutes to prevent delivery of drug to nasal
i. Collaboration
mucosa and general circulation
ii. Communication
c. May cause retinal detachment
iii. Assessment
d. Low fat diet
c. Competence with respect to attitudes
i. Proactive Stance
ii. Advocate
Peroneal nerve
d. Personal characteristics 1. Ito ay isang malaking HUGOT.
i. Health role model a. Harap ng binti
2. Definition: Process of enabling people to increase b. Gilid ng binti
control over determinants of health and thereby c. Taas ng paa
improve their health. 2. When injured, may cause foot drop
3. Strategies: 3. How to assess: Ask the client to dorsiflex foot
a. Advocacy 4. If sciatica is injured (such as when injection in
b. Enabling children in the inner medial part of the buttocks), it
c. Mediating may also cause peroneal nerve dysfunction (it
4. 5 Priority Action Areas: (PECSS) branches out from the sciatica nerve)
a. Build a healthy public policy (Policy) 5. In hypocalcemia, if the nerve is tapped, it reacts in
b. Create supportive environments for health similar way as in Chvostek sign but in the foot.
(Environment)
c. Strengthen community action for health Bone Scan
(Community)
1. Client Preparation:
d. Develop personal skills (Skills)
a. Assess client’s understanding and get consent
e. Reorient health services (Services)
b. Void prior to procedure
5. Encompasses political and social interventions
c. Food and fluid is okay prior to procedure
6. Principles:
d. Radioactive material is injected every 2-3 hours
a. Incorporate health promotion as an integral part
so that it concentrates on the bone
of nursing practice
e. Observe for redness or swelling
b. Empower individuals
f. If hematoma occurs, give warm soaks
c. Collaborate with other disciplines
g. 4-6 glasses in the 2-3 hour periods to facilitate
d. Evaluate outcomes
renal excretion of the radioactive material
e. Participate in EBP
h. Scan takes 30-60 minutes.
f. Patient advocacy
i. Sedative may be given to decrease client
7. Responsibilities:
agitation
a. Assess health needs
b. Build capacity

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2. Client Teaching:
a. Remove jewelry or any metals
b. Machine makes a clicking sound
c. NO need for special handling of urine and fecal
handling

Burnout
1. 3 Areas of s/sx
a. Emotional Exhaustion
b. Alienation from (job-related) activities
c. Reduced Performance
2. Diagnostics: Maslach Burnout Inventory
3. There is NO:
a. Lack of self-esteem
b. Hopelessness
c. Suicidal tendencies
d. These 3 are characteristics of depression
4. EVOF

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