Podcast
Questions and Answers
Which of the following is NOT a characteristic of melanoma?
Which of the following is NOT a characteristic of melanoma?
What is the name of the formula that is used to calculate fluid resuscitation for burns?
What is the name of the formula that is used to calculate fluid resuscitation for burns?
Hypovolemic shock is a complication of burns.
Hypovolemic shock is a complication of burns.
True (A)
What is the condition that is characterized by low urine osmolality, high serum osmolality, and hypernatremia?
What is the condition that is characterized by low urine osmolality, high serum osmolality, and hypernatremia?
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What are the three main categories of burns?
What are the three main categories of burns?
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What does the "T" in the TNM classification stand for?
What does the "T" in the TNM classification stand for?
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What are the four main signs and symptoms of type 1 diabetes?
What are the four main signs and symptoms of type 1 diabetes?
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What are the three main interventions to combat nausea related to chemotherapy?
What are the three main interventions to combat nausea related to chemotherapy?
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Acromegaly is a condition that is characterized by the overproduction of growth hormone.
Acromegaly is a condition that is characterized by the overproduction of growth hormone.
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What are two things you should monitor for in a patient with diabetes insipidus?
What are two things you should monitor for in a patient with diabetes insipidus?
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A sign of infection following a burn is decreased or absent white blood cell count (absolute neutrophil count [ANC] <500 cells/mm³).
A sign of infection following a burn is decreased or absent white blood cell count (absolute neutrophil count [ANC] <500 cells/mm³).
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Which of the following is a sign or symptom of hypovolemia?
Which of the following is a sign or symptom of hypovolemia?
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What is the main difference between type 1 diabetes and type 2 diabetes?
What is the main difference between type 1 diabetes and type 2 diabetes?
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The Somogyi Phenomenon is a condition in which nocturnal hypoglycemia leads to rebound hyperglycemia in the morning.
The Somogyi Phenomenon is a condition in which nocturnal hypoglycemia leads to rebound hyperglycemia in the morning.
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Match the following interventions with their corresponding condition:
Match the following interventions with their corresponding condition:
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Study Notes
ABCDEs of Melanoma
- Asymmetry: One half of the lesion doesn't match the other.
- Border: Irregular, ragged, or blurred edges.
- Color: Varies, including shades of tan, brown, black, white, red, or blue.
- Diameter: Larger than 6 mm (pencil eraser size).
- Evolving: Changes in size, shape, color, or symptoms (itching, tenderness, bleeding).
TNM Classification
-
T (Tumor): Describes the size and extent of the primary tumor.
- TO: No primary tumor present.
- T1-T4: Increasing size and/or extent of the tumor.
-
N (Node): Indicates if cancer has spread to lymph nodes.
- NO: No lymph node involvement.
- N1-N3: Increasing lymph node involvement.
-
M (Metastasis): Presence of distant metastasis.
- M0: No metastasis.
- M1: Presence of metastasis.
Chemotherapy Effects on Stem Cells and Bone Marrow
- Impact: Bone marrow suppression (myelosuppression) reduces RBC, WBC, and platelet production.
- Complications: Anemia, neutropenia, and thrombocytopenia.
- Assessment: Monitor CBC, infections, bleeding, and fatigue.
- Neutropenia: Report fever (≥100.4°F or 38°C), chills/sweating, or signs of infection (sore throat, cough, redness, etc.). Decreased or absent WBC count (ANC <500 cells/mm³).
Interventions to Combat Fatigue Related to Radiation Therapy
- Encourage short naps and frequent rest breaks.
- Encourage physical activity (e.g., walking).
- Provide suitable nutritional support to combat weight loss.
- Promote adequate hydration and a regular sleep schedule.
Interventions to Combat Nausea Related to Chemotherapy
- Administer antiemetics (e.g., ondansetron) 30-60 minutes before treatment.
- Provide small, frequent meals.
- Avoid strong odors, spicy, or greasy foods.
- Encourage hydration with clear fluids.
Spinal Cord Compression Interventions
- Administer corticosteroids for inflammation reduction.
- Prepare for radiation or surgical decompression if needed.
- Maintain proper body alignment and use supportive devices.
- Monitor for worsening neurological symptoms.
Pain Management for the Cancer Patient
- Use a multimodal approach (NSAIDs, opioids, adjuvants).
- Implement non-pharmacological methods (relaxation, massage, acupuncture).
- Regularly evaluate and reassess pain control effectiveness.
Secondary Measures to Prevent Cancer
- Screenings (mammograms, colonoscopies, Pap smears, HPV vaccination).
- Cessation of smoking.
- Limit alcohol intake and practice sun protection.
Prostate Cancer Risk Factors
- Age >50 years
- Family history of prostate cancer
- African American ethnicity
- High-fat diet and obesity
Skin Cancer Risk Factors and Characteristics
- Risk factors: Fair skin, excessive UV exposure, family history, hx of sunburns.
- Characteristics: Persistent non-healing sores, pearly/waxy bumps, or scaly patches.
Fluid, Electrolyte, and Acid-Base Imbalances
- Interventions for UAP: Measure intake/output, obtain vital signs, assist with ambulation/hygiene, report abnormal findings.
- Hypotonic Solution Interventions: Monitor for fluid shifts and cerebral edema; assess for overhydration (confusion, lethargy); use cautiously in patients with head injuries or increased ICP.
- Lasix (Furosemide) Interventions: Monitor electrolytes (esp. potassium); assess for hypovolemia (dizziness, hypotension); encourage potassium-rich foods/supplementation.
-
Interpreting ABGs:
- Metabolic Acidosis: pH <7.35, HCO3¯ < 22 mEq/L.
- Metabolic Alkalosis: pH > 7.45, HCO3¯ > 26 mEq/L.
- Respiratory Acidosis: pH <7.35, PaCO2 > 45 mmHg.
- Respiratory Alkalosis: pH >7.45, PaCO2 < 35 mmHg.
- Electrolyte Replacement for DKA: Replace potassium once levels fall below normal; administer IV fluids (0.9% NS or 0.45% NS); administer insulin to lower blood glucose.
- Fluid Replacement for Diarrhea: Use isotonic fluids (0.9% NS or LR).
Lab Values and Interventions
- Potassium: 3.5-5.0 mEq/L (hypokalemia: cautious IV or oral administration).
- Sodium: 135-145 mEq/L (monitor for hyper/hyponatremia).
- Calcium: 8.5-10.5 mg/dL (monitor for tetany in hypocalcemia).
Integumentary Problems
- Atypical Nevi: Irregular borders, uneven pigmentation; larger than normal moles, may be raised or flat with mixed colors (brown, tan, pink, black).
- Melanoma: Dark brown/black patches/nodules with irregular edges; rapid growth/changes; bleeding, itching, or ulceration.
- Actinic Keratosis: Rough, scaly patches on sun-exposed areas; often pink, red, or brown; considered precancerous (squamous cell carcinoma).
- Basal Cell Carcinoma: Pearly, waxy bump or flat lesion with a rolled edge; may have visible blood vessels (telangiectasia); slow-growing; often on sun-exposed areas.
Burns
- Rule of Nines: Estimates burn surface area.
- Classification: Superficial (red, painful, dry), Partial-thickness (blisters, red, moist, painful), Full-thickness (white, charred, leathery, painless).
- Priority Nursing Interventions: Airway management (smoke inhalation assessment), fluid resuscitation (Parkland formula), wound care (aseptic techniques). Pain control (IV opioids).
- Electrical Burns Intervention: Cardiac monitoring for arrhythmias, assess entry and exit wounds, monitor for compartment syndrome and kidney function (rhabdomyolysis).
- Emergency Interventions: Remove patient from burn source, cool burn with lukewarm water, cover burn with clean, dry cloth, assess airway and circulation.
Hormone Alterations in Burns
- Increased cortisol and catecholamines (stress response)
- ADH secretion leading to fluid retention
- Insulin resistance and hyperglycemia
Diabetes Mellitus
- Type 1: Polyuria, polydipsia, polyphagia, weight loss, fatigue, blurred vision, ketoacidosis.
- Type 2: Polyuria, polydipsia, polyphagia (less common than Type 1), fatigue, recurrent infections, poor wound healing, gradual onset.
- Gestational Diabetes: Screen for gestational diabetes (OGTT). Provide dietary counseling and education, monitor fetal growth and maternal blood glucose.
- Interventions for Type 1 Diabetes After Insulin Administration: Monitor for hypoglycemia (sweating, shakiness, confusion); ensure patient consumes a meal within 15-30 mins of rapid-acting insulin.
- Hyperglycemia: Polyuria, polydipsia, dry mouth.
- Somogyi Effect: Nocturnal hypoglycemia leading to rebound hyperglycemia in the morning. Intervention: adjust evening insulin or provide bedtime snack.
Dietary Patient Teaching for New Diabetic Patients
- Carbohydrate counting, balanced meals, avoid sugary/processed carbs, include high-fiber foods.
Diabetic Patients and Contrast Administration
- Hold metformin 24-48 hours before and after contrast. Monitor renal function (BUN/creatinine), ensure adequate hydration.
DKA Interventions
- Fluid replacement (0.9% or 0.45% NS).
- Administer insulin drip, monitor glucose hourly, correct electrolyte imbalances (e.g., potassium).
Patient Education for Type 2 Diabetes
- Encourage physical activity/weight loss, teach self-monitoring of blood glucose (SMBG), stress the importance of medication adherence.
Endocrine Problems
- Hypopituitarism: Fatigue, weight gain, infertility, hypotension, low libido, cold intolerance.
- SIADH: Fluid restriction (500-1000 mL/day); administer diuretics and hypertonic saline if severe; monitor for hyponatremia (confusion).
Diabetes Insipidus Lab Values to Monitor
- Low urine osmolality (<200 mOsm/kg).
- High serum osmolality (>295 mOsm/kg).
- Hypernatremia (Na >145 mEq/L).
Assessing Medication Effectiveness for Hypothyroidism
- TSH levels normalize (decrease if elevated). Improvement in symptoms (fatigue, cold intolerance).
Addison's Disease Interventions in Times of Stress
- Increase glucocorticoid dosing as prescribed.
- Monitor for hypotension and electrolyte imbalances.
- Administer IV hydrocortisone if necessary.
Cushing Syndrome
- Increased cortisol levels (24-hour urine cortisol test).
- Hyperglycemia, hypokalemia.
Acromegaly Assessment
- Enlarged hands, feet, and facial features.
- Joint pain, thickened skin.
- Sleep apnea and hypertension.
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Description
This quiz covers essential concepts related to melanoma, including the ABCDEs of melanoma assessment and the TNM classification system for cancer staging. Additionally, it explores the effects of chemotherapy on stem cells and bone marrow function. Test your understanding of these vital topics in dermatology and oncology.
