Acute Illness Midterm Notes PDF

Acute Illness Midterm Notes Week 1: The Nursing Process The nursing process consists of assessment, diagnosis, planning, implementation, and evaluation. Evaluation is the final phase, assessing the effectiveness of interventions. Cancer Overview Over 200 diseases char...

Acute Illness Midterm Notes Week 1: The Nursing Process The nursing process consists of assessment, diagnosis, planning, implementation, and evaluation. Evaluation is the final phase, assessing the effectiveness of interventions. Cancer Overview Over 200 diseases characterized by uncontrolled cell growth and defective differentiation. Causes: genetic mutations, carcinogens (chemical, radiation, viral, genetic factors), and lifestyle (smoking, alcohol, obesity). Cancer Classification & Staging Benign vs. Malignant: Benign tumors do not spread, while malignant tumors invade other tissues. Staging (TNM System - WHO): o T (Tumor size) o N (Lymph node involvement) o M (Metastasis) Stages: o Stage 0 – Cancer in situ o Stage I – Localized tumor o Stage II – Limited local spread o Stage III – Extensive spread o Stage IV – Metastasis Cancer Treatment Modalities 1. Surgery – Tumor removal, sometimes combined with other treatments. 2. Chemotherapy – Kills cancer cells; systemic treatment.  3. Radiation Therapy – Destroys cancer cells using high-energy radiation. 4. Bone Marrow Transplant – Used for blood cancers, replaces damaged bone marrow. 5. Hormonal Therapy – Used for hormone-sensitive cancers. 6. Palliative Care – Focuses on comfort and symptom management. Nursing Management in Cancer Care Pain Management: WHO pain ladder approach. Fatigue: Encourage rest, hydration, and nutrition. Infection Prevention: Monitor neutropenia, implement precautions. Skin Reactions: Care for radiation burns and skin integrity. GI Effects: Anti-emetics, dietary modifications. Pulmonary Effects: Manage pneumonitis and fibrosis. Obstructive & Metabolic Emergencies in Cancer Superior Vena Cava Syndrome – Obstruction of the superior vena cava. Spinal Cord Compression – Tumor pressing on the spinal cord. Tumor Lysis Syndrome – Rapid cancer cell breakdown releasing toxins. Breast Cancer Risk Factors: Age >60, family history, early menarche, late menopause, obesity, hormone therapy. Symptoms: Lump, nipple discharge, peau d’orange, nipple retraction. Diagnosis: Mammography, biopsy, hormone receptor status. Treatment: Surgery (lumpectomy, mastectomy), chemotherapy, radiation, hormonal therapy. Pain Management Types of Pain: Acute, chronic, breakthrough. Pain Assessment: OPQRSTUV o O: Onset o P: Provocative/Palliative o Q: Quality  o R: Region o S: Severity o T: Timing o U: Understanding o V: Values Transitions in Care Nurses ensure smooth transitions between care settings, preventing medication errors and continuity of care. 25 Multiple-Choice Questions with Answers 1. What is the final phase of the nursing process? A) Planning B) Diagnosis C) Implementation D) Evaluation 2. Which of the following is a modifiable risk factor for cancer? A) Genetics B) Smoking C) Gender D) Age 3. What is the primary cause of cancer? A) Bacterial infections B) Genetic mutations C) Vitamin deficiencies D) Excessive exercise 4. Which stage of cancer indicates metastasis? A) Stage 0 B) Stage I C) Stage III D) Stage IV 5. The TNM classification system evaluates: A) The patient’s response to chemotherapy B) Tumor size, lymph node involvement, and metastasis C) Blood pressure changes in cancer patients D) The effectiveness of surgery 6. Which therapy uses high-energy radiation to kill cancer cells? A) Chemotherapy B) Surgery C) Radiation therapy D) Immunotherapy 7. The main goal of palliative care is: A) Cure cancer B) Improve quality of life C) Prevent recurrence D) Remove tumors surgically 8. Which treatment involves using chemicals to kill cancer cells? A) Surgery B) Radiation therapy C) Chemotherapy D) Immunotherapy 9. What is the most common side effect of chemotherapy? A) Hypertension B) Myelosuppression C) Increased appetite D) Muscle gain 10. Which organ is most commonly affected by metastasis? A) Liver B) Pancreas C) Stomach D) Heart 11. What is the main purpose of tumor markers? A) To cure cancer B) To indicate the presence of cancer C) To measure body fat D) To prevent tumor growth 12. What is the biggest risk of bone marrow transplant? A) Weight gain B) Graft-versus-host disease C) Nausea D) High blood pressure 13. Which hormone therapy is used for breast cancer? A) Insulin B) Estrogen blockers C) Thyroid medication D) Testosterone 14. Which symptom is commonly associated with breast cancer? A) Knee pain B) Nipple discharge C) Blurred vision D) High fever 15. Which nursing intervention helps manage fatigue in cancer patients? A) Encouraging bed rest B) Avoiding fluids C) Encouraging mild physical activity D) Avoiding all activity 16. Which emergency occurs when a tumor compresses the spinal cord? A) Superior vena cava syndrome B) Spinal cord compression C) Bowel obstruction D) Septic shock 17. What is the major concern with febrile neutropenia? A) High blood pressure B) Increased infection risk C) Weight loss D) Nausea 18. Which pain management strategy is most effective for chronic pain? A) PRN medication use B) Around-the-clock pain medication C) Ignoring mild pain D) Avoiding opioid medications 19. Which of the following can cause skin reactions during cancer treatment? A) Radiation therapy B) Physical therapy C) Surgery D) Hormonal therapy 20. The primary cause of death in cancer patients is: A) Cardiac arrest B) Infection C) Bleeding disorders D) Malnutrition 21. What is an important nursing role during transitions in care? A) Providing medication reconciliation B) Ignoring patient concerns C) Reducing pain only D) Avoiding patient involvement 22. What is the first step in the LEARN model for cultural competence? A) Explain your perception B) Listen to the patient C) Recommend treatment D) Negotiate agreement 23. Which factor is a social determinant of health? A) Smoking B) Income level C) Genetic predisposition D) Cancer stage 24. What should a nurse assess in a cognitively impaired patient for pain? A) Blood pressure B) Vocalizations C) Heart rate D) Skin color 25. What is the first letter in the OPQRSTUV pain assessment model? A) Quality B) Onset C) Severity D) Understanding Week 2: Respiratory Assessment History: smoking history (packs per day, years smoked), environmental exposures, past respiratory diseases (COPD, asthma, TB, pneumonia). PQRST for symptom analysis: o Cough – duration, sputum production. o Shortness of breath – with activity level. o Chest pain – associated with breathing. o Level of consciousness – orientation, medications affecting breathing. Diagnostic Tests Radiology: CXR, CT scan, MRI, VQ scan, pulmonary angiography, PET scan. Endoscopic Exams: Bronchoscopy, lung biopsy, thoracentesis. Pulmonary Function Tests: Spirometry, peak expiratory flow meter. Blood Tests: Hemoglobin (Hgb), hematocrit (Hct), arterial blood gases (ABGs). Pulse Oximetry: Measures SaO₂. Obstructive vs. Restrictive Pulmonary Disease Obstructive Diseases: Increased airway resistance (asthma, COPD, emphysema, chronic bronchitis). Restrictive Diseases: Decreased lung compliance, limited expansion (pulmonary fibrosis, pulmonary edema). Chronic Obstructive Pulmonary Disease (COPD) Pathophysiology: o Irreversible airflow limitations.  o Mucus hypersecretion, ciliary dysfunction. o Hyperinflation, gas exchange abnormalities. Risk Factors: Smoking, air pollution, infections, genetics. Symptoms: Chronic cough, sputum production, dyspnea, wheezing, barrel chest, cyanosis. Complications: Cor pulmonale, acute exacerbations, respiratory failure. Asthma Triggers: Allergens, exercise, respiratory infections. Symptoms: Wheezing, breathlessness, cough, tight chest. Severe Attack: Silent chest, PEFR 30/min, pulse >120/min. Status Asthmaticus: Life-threatening, unresponsive to treatment. Pneumonia Types: o Community-acquired (CAP) o Hospital-acquired (HAP) o Ventilator-associated (VAP) o Aspiration pneumonia Symptoms: Fever, chills, dyspnea, productive or dry cough, pleuritic chest pain, crackles. Complications: Pleural effusion, atelectasis, bacteremia. Treatment: Antibiotics, hydration, oxygen therapy. Pulmonary Embolism (PE) Cause: Blockage of pulmonary arteries by a thrombus, fat, or air embolus. Symptoms: Sudden dyspnea, chest pain, hemoptysis, tachycardia, hypoxia. Diagnostics: D-dimer test, CT pulmonary angiography. Treatment: Anticoagulants, thrombolytics, surgical removal. Oxygen Therapy Methods: Nasal cannula, face mask, non-rebreather mask, mechanical ventilation. Complications: Oxygen toxicity, carbon dioxide narcosis (COPD patients), infection risk. Lung Cancer Risk Factors: Smoking (primary), exposure to carcinogens. Symptoms: Persistent cough, hemoptysis, weight loss, hoarseness. Treatment: Surgery, radiation, chemotherapy, targeted therapy. 25 Multiple-Choice Questions with Answers 1. Which diagnostic test measures oxygen saturation in the blood? A) CT scan B) Pulse oximetry C) MRI D) VQ scan 2. What is the most common cause of COPD? A) Asthma B) Smoking C) Viral infections D) Poor diet 3. Which symptom is a hallmark sign of asthma? A) Chest pain B) Hemoptysis C) Wheezing D) Bradycardia 4. What type of pneumonia is acquired outside of healthcare settings? A) Ventilator-associated pneumonia (VAP) B) Hospital-acquired pneumonia (HAP) C) Community-acquired pneumonia (CAP) D) Aspiration pneumonia 5. Which condition is characterized by hyperinflation of the lungs and barrel chest? A) Pulmonary edema B) COPD C) Pneumonia D) Pulmonary embolism 6. The term “silent chest” in asthma suggests: A) Mild asthma attack B) Life-threatening bronchospasm C) Recovery phase D) Early onset of asthma 7. Which test is most definitive for diagnosing a pulmonary embolism? A) Chest X-ray B) D-dimer test C) CT pulmonary angiography D) ABG analysis 8. What is the first-line bronchodilator for acute asthma attacks? A) Fluticasone B) Salbutamol (Albuterol) C) Montelukast D) Theophylline 9. The most common early symptom of lung cancer is: A) Shortness of breath B) Hemoptysis C) Persistent cough D) Weight gain 10. Which position helps a patient with COPD breathe more easily? A) Supine B) Lying on the left side C) Tripod position D) Trendelenburg 11. Which assessment finding suggests a pleural effusion? A) Wheezing B) Decreased breath sounds C) Crackles D) Stridor 12. Which intervention is most effective in preventing ventilator-associated pneumonia (VAP)? A) Administering corticosteroids B) Frequent suctioning C) Hand hygiene and oral care D) Increasing ventilator oxygen 13. What is the major complication of pulmonary edema? A) Hypoxia B) Bronchospasm C) Lung cancer D) Pleural effusion 14. In pneumonia, what does purulent sputum indicate? A) Viral infection B) Bacterial infection C) Normal lung function D) Aspiration pneumonia 15. What is a primary goal in asthma management? A) Complete cure B) Reduction of rescue inhaler use C) Increased mucus production D) Increased respiratory rate 16. What is the primary cause of cor pulmonale? A) Pulmonary hypertension B) COPD C) Pneumothorax D) Lung cancer 17. What lung sound is most common in COPD? A) Wheezing B) Stridor C) Crackles D) Pleural rub 18. Which oxygen delivery method provides the highest concentration? A) Nasal cannula B) Simple face mask C) Non-rebreather mask D) Venturi mask 19. Which therapy is first-line for pulmonary embolism? A) Surgery B) Anticoagulants C) Bronchodilators D) Chest tube insertion 20. What ABG change is most common in COPD exacerbation? A) Respiratory alkalosis B) Respiratory acidosis C) Metabolic acidosis D) Metabolic alkalosis 21. Which disorder is characterized by fluid accumulation in the lungs? A) COPD B) Pneumonia C) Pulmonary edema D) Pulmonary embolism 22. A COPD patient experiencing increased dyspnea should first: A) Increase oxygen flow rate B) Perform pursed-lip breathing C) Lie flat D) Hold breath 23. What is the primary cause of a tension pneumothorax? A) Increased mucus B) Air trapped in pleural space C) Excessive coughing D) High CO₂ levels 24. Which medication is used for asthma maintenance therapy? A) Salbutamol B) Prednisone C) Montelukast D) Epinephrine 25. Which intervention helps clear secretions in pneumonia? A) Bed rest B) Deep breathing and coughing C) Increased oxygen D) Bronchodilators