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Questions and Answers
Which demographic group is most associated with a high incidence of HIV infection?
What is the critical threshold for CD4 count that indicates an AIDS diagnosis?
Which of the following modes of transmission is considered least likely to spread HIV?
What should be avoided by pregnant women living with HIV to prevent transmission to the baby?
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Which cancer is most commonly associated with patients living with HIV?
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What is the primary purpose of myeloablative chemotherapy in stem cell transplants?
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Which of the following is NOT a part of the pre-blood transfusion process?
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Which transfusion reaction is characterized by pulmonary edema and respiratory distress?
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What is a common recommendation for managing TACO during blood transfusion?
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What signs indicate a hemolytic transfusion reaction?
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In which situation should the nurse consider administering diphenhydramine during a transfusion?
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How long should a PRBC transfusion typically last at maximum?
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What allergen-related symptom would warrant the administration of Diphenhydramine?
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What is a common symptom of leukostasis?
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Which leukemic phase is characterized by symptomatic presentation?
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What type of cells is predominantly seen in chronic lymphocytic leukemia (CLL)?
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Which vital sign change is most critical to monitor in patients with autoimmune disorders undergoing treatment?
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Which organ infiltration can lead to severe abdominal pain in leukemia patients?
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Which of the following is considered a '3 enemy' factor that could exacerbate symptoms in patients with autoimmune disorders?
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What is one of the B symptoms commonly associated with lymphoma?
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What is a major risk factor for developing non-Hodgkin's lymphoma?
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What is an essential aspect of patient education for someone undergoing treatment for an autoimmune disorder?
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In order to prevent complications during physical therapy for patients with autoimmune disorders, what should be prioritized?
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Which virus is linked to the development of lymphomas, particularly in immunocompromised patients?
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What lab test is prioritized for diagnosing leukemia?
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Which lab work biomarker is commonly monitored to assess inflammation in patients with autoimmune disorders?
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Which symptom is NOT typical of neutropenia in leukemia patients?
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Which type of lymphoma is typically associated with the presence of Reed-Sternberg cells?
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What is a critical platelet count that indicates a risk for bleeding?
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Which treatment is indicated for cardiac tamponade?
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What laboratory marker indicates the presence of disseminated intravascular coagulation (DIC)?
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What common symptom is associated with leukostasis when the white blood cell count exceeds 100,000-300,000?
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Which of the following is not a common sign of cardiac tamponade?
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Which type of leukemia is characterized by a high percentage of immature cells and is known to be more fatal?
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What is a common management strategy for patients with sepsis?
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Which risk factor is associated with the development of leukemia?
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What symptom might indicate fluid overload when bombarding with normal saline hydration?
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In chronic myelogenous leukemia (CML), what can it potentially progress to?
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Study Notes
Kidneys and Associated Disorders
- Bradycardia can impact renal function.
- Back pain may indicate renal calculi; increase fluid intake to help.
- Severe abdominal pain may result from quiet intestinal contractions or constipation; laxatives can relieve this.
- Polyuria can occur due to bladder issues.
- Behavioral changes include depression, lethargy, and decreased level of consciousness (LOC).
- Treatment includes aggressive normal saline hydration; consider calcitonin and pamidronate drip.
- Monitor for signs of fluid overload, such as pulmonary edema.
Disseminated Intravascular Coagulation (DIC)
- Approximately 40% of sepsis patients develop DIC.
- Symptoms include massive bleeding from three unrelated sites.
- Vital signs show hypotension and tachycardia.
- Management involves blood transfusion and treating the underlying cause.
- Lab tests to monitor include elevated D-dimer and fibrin split products (FSP/FDP), biomarkers for DIC.
Cardiac Tamponade and Effusion
- Cardiac tamponade can occur from pleural or pericardial effusion.
- Symptoms include dyspnea, tachycardia, reduced LOC, and a feeling of impending doom.
- Immediate treatment involves pericardiocentesis to remove excess fluid.
Leukostasis
- Occurs when white blood cell (WBC) count exceeds 100,000-300,000.
- Leads to hyperviscosity syndrome, increasing the risk of clots and serious complications like stroke, myocardial infarction, or respiratory distress.
Thrombocytopenia
- Critical level is below 20,000 platelets.
- Major sites for bleeding risks include the brain, lungs, and gastrointestinal tract.
- Treatment may include oprelvekin, with platelet transfusions indicated for counts below 20,000.
Sepsis Management
- Start with IV fluids, followed by cultures and sensitivity tests, then initiate broad-spectrum antibiotics.
- Monitor for febrile neutropenia, especially in older adults showing altered mental status (AMS).
- Uphold neutropenic precautions and follow a neutropenic diet.
Leukemia Overview
- Predominantly affects the older population, particularly Caucasian males.
- Immature cell prevalence differentiates acute (20% immature cells) from chronic forms.
- Risk factors include family history, radiation exposure, chromosomal abnormalities, and toxic chemical exposure.
Types of Leukemia
- Acute Myelogenous Leukemia (AML): Most fatal; involves immature blood cells.
- Chronic Myelogenous Leukemia (CML): Often asymptomatic; contains mature, dysfunctional cells; can transition to AML.
- Acute Lymphocytic Leukemia (ALL): Common in pediatrics; involves immature lymphocytes.
- Chronic Lymphocytic Leukemia (CLL): Slow growth; involves mature yet ineffective lymphocytes.
Clinical Manifestations of Leukemia
- Bone marrow infiltration leads to cytopenia, causing symptoms like fatigue, bleeding, and recurrent infections.
- Organ infiltration may result in hepatomegaly, lymphadenopathy, spleen enlargement, and bone pain.
- Hypermetabolic symptoms include weight loss and night sweats.
Lymphoma
- Cancer of lymphoid tissue affecting lymph nodes, blood, spleen, and bone marrow.
- Demographic factors: Most prevalent in males aged 15-35 or over 35, and those with HIV/AIDS.
- Hodgkin's lymphoma (HL) features Reed-Sternberg cells, while non-Hodgkin’s lymphoma (NHL) is more common and has a higher fatality rate due to extra-nodal involvement.
HIV/AIDs Demographics and Transmission
- High-risk groups include MSM, IV drug users, young adults, and healthcare workers.
- Transmission occurs via bodily fluids (blood, semen, breast milk) and sexual activity.
- Critical CD4 count below 200 signifies progression to AIDS.
HIV Clinical Stages
- Acute phase: Flu-like symptoms during seroconversion.
- Asymptomatic phase: Stable CD4 count; longest stage.
- Management focuses on medication adherence, infection control, and monitoring for opportunistic infections.
Nursing Management for Autoimmune Disorders
- Emphasize vital signs, rehabilitation collaboration, medication compliance, and infection control.
- Educate on diet, exercise, and skin integrity while monitoring for disease progression and treatment side effects.
Blood Transfusion Protocols
- Ensure informed consent, proper blood matching, and verification by two nurses before administering transfusions.
- Monitor vital signs closely during the transfusion, especially in the first 30 minutes.
- Be aware of potential transfusion reactions, including TRALI, TACO, hemolytic reactions, febrile responses, allergic reactions, and bacterial contamination.
Practice Questions
- Prioritize medication administration based on patient needs and condition.
- Assess for common chemotherapy side effects when receiving treatment.
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Description
This quiz covers various kidney-related conditions such as bradycardia, renal calculi, and symptoms associated with urinary issues. It also addresses treatments like hydration and medication options. Test your knowledge on the management of kidney disorders and related complications.
