Ambulatory Oncology Divisional Education | Baamboozle - Baamboozle

A patient receiving a blood transfusion complains of flank pain and presents with hematuria. What type of transfusion reaction is the patient exhibiting?

Hemolytic - What is the treatment?

A patient is receiving a blood transfusion and presents with uticaria, pruritius, increase of temperature of one degree celcius. What type of reaction is the patient presenting with? Treatment

Anaphylactic- stop transfusion, send to lab, draw labs, etc.

I am the most common cause of DIC?

Sepsis

Name three triggers for DIC

Infection, burns, brain injury, sepsis, shock, acute liver disease, obstetrical complications

What disorders does this physical assessment findings correlate to?

DIC

I am consumptive coagulopathy and defibrination syndrome caused by tissue damage, vessel damage or infections.

Disseminated intravascular coagulation (DIC)

A patient has a diagnosis of Thrombotic thrombocytopenia purpura (TT)- what medical treatment is contraindicated and why?

Platelet transfusion - transfused platelets can aggregate resulting in MI, CVA, coma or death

What is the medical plan of care for HTT?

Stop Heparin, put allergy in chart, medical alert bracelet- Can administer nonheparin anticoagulant

Hallmark of ____________ is a decrease in platelet count of >50% from the patient's baseline, even if the total count remains within the "normal" range (above 150,000 mm3).

Heparin-Induced Thrombocytopenia (HTT)

What is drug that is used for ITP that inhibit production of anti-platelet antibodies?

Corticosteroids

What are the two tests used to diagnosis ITP?

Platelet count and bone marrow aspirate (biopsy)

How would the nurse document this physical assessment finding?

Petechiae

This disorder can follow a virus - who am I?

Idiopathic thrombocytopenia purpura (ITP) or Autoimmune Thrombocytopenia

I am a low platelet count - what is my name?

Thrombocytopenia

Anaphylaxis usually begins within a few minutes after exposure to the allergen and symptoms are usually evident within 15 minutes?

True

What are some non-pharmacological interventions when dealing with anaphylaxis?

Place patient in Trendelenburg, maintain airway and adequate ventilation,O2 sats,administer O2 if needed

Can epinephrine be given IV for first line treatment for anaphylaxis?

NO. IM is first line treatment

What is a biphasic anaphylactic reaction?

second wave of severe allergic reaction symptoms often within 72 hours without further exposure

How often can you administer epinephrine?

Every 5 minutes to max of 3 doses

If a second dose of epinephrine is given what location is to be used?

other thigh

What location is best to administer IM epinephrine?

Deep IM to mid- anterior lateral thigh (Vastus lateralis muscle)

What dose of epinephrine IM is to be given for an adult?

0.3mg IM (0.3ml)

In an emergency situation, can an RN prescribe Epinephrine IM for a LPN to administer? True or False

False. The RN who prescribes needs to administer

A 68-year-old male with a history of lung cancer presents with facial edema, distended neck veins, and dyspnea. He reports worsening cough and hoarseness over the past week. What is the most likely diagnosis?

Superior Vena Cava Syndrome

Spinal cord compression

Cardiac Tamponade

malignant Bowel Obstruciton

True or false: All central lines are flushed using a "pulse" technique to decrease fibrin build up.

True

Scrubbing the hub for _________ is an effective method for reducing CLABSIs.

15 seconds

5 seconds

10 seconds

20 seconds

When someone has severe sepsis, their chances of survival drops by almost 8% for every _________ without treatment?

Hour

Second

Day

Minute

Fever or hypothermia, tachycardia and confusion are all common signs of what?

Sepsis

Anaphylaxis

Deep Vein Thrombosis

Hypoglycemia

Harry has glioblastoma. He is admitted for head ache. VS: 182/62, HR45, RR7. What do you suspect is occurring?

Increased Intracranial Pressure

Tumor Lysis Syndrome

Hypoglycemia

Syndrome of Inappropriate Antidiuretic Hormone

Arnold is receiving daunorubicin via L. PICC line. He calls out and states that his left arm is burning. What actions should you take?

Stop the infusion, check for blood return,

Slow the infusion, reassure the patient

Continue the infusion, tell the patient this is normal

Call the doctor!

Kim is receiving paclitaxel for breast cancer. She calls out and tells you that she is "feeling winded and my lips are feeling fat." What do you suspect? What are your actions?

Hypersensitivity reaction. Stop the infusion

Infiltration, change the IV site.

Extravasation, stop the infusion.

Keep the infusion going, she's a hypochondriac

Lucy has acute myeloid leukemia. She is receiving chemotherapy and her labs are as follows: K= 6.0 mEq/L, Uric Acid= 9mg/dL, Phosphorus= 5.8mg/dL, Creatinine= 2.1mg/dL. What do you suspect is happening?

Tumor Lysis Syndrome

Spinal cord compression

Hypercalcemia

Diabetic Ketoacidosis

Ruby has ALL. She has a DL port in place. Ruby has complaints of her arm feeling "tight" and you note that her arm is red, warm, and swollen. What do you expect and what should your next steps be?

DVT; measure extremity, notify provider, remove and culture

Extravasation, notify provider, remove and culture

Infiltration, measure extremity, notify provider

Fibrin plug, administer tPa, flush with 20 cc saline

Pat has lymphoma and is actively receiving chemotherapy. She has a left DL port in place for her chemo. Pat arrives to the clinic with upper extremity swelling, JVD, and periorbital edema. What do you suspect is happening?

Superior Vena Cava Syndrome

Tumor Lysis Syndrome

Hypercalcemia

Spinal Cord Compression

Rhonda has renal cancer. She is experiencing polyuria and altered mental status. Serum calcium is 14mg/dL. What do you suspect and what treatments do you anticipate?

Hypercalcemia; Saline fluids, Calcitonin, Biphosphonates

Hypocalcemia, sodium bicarb, steroids

Hyperphosphatemia, calcitonin, steroids, lasix

Nothing until she is off chemotherapy

Sally Sue has breast cancer. She has complaints of bowel and bladder incontinence, and back pain. What do you suspect is occurring?

Spinal cord compression

Superior vena Cava Syndrome

Hypercalcemia

Tumor Lysis Syndrome

Bob has APL. He is bleeding from his gums. What might be happening with Bob?

Disseminated Intravascular Coagulation (DIC)

Pneumothorax

Myocardial Infarction

Too many aspirin