Patho II Exam II Concepts

Shock

Poor perfusion

S/s of shock

• Pale, cool skin

• Rapid, shallow respirations

• Restlessness and lethargy

• Thirsty and acidotic

• Tachycardic and hypotensive

Hypovolemic shock

Severe blood or fluid loss; Trauma, hemorrhage, burns, severe V/D

Septic shock

Caused by widespread infection or sepsis; Bacteria, fungi, or parasite infection

Anaphylactic shock

Can be from foods, medications, insect bite; Acute allergic reaction pcn, nuts, shellfish

Neurogenic shock

SCI or damage to the nervous system; Trauma to spinal cord/medulla, drugs that depress CNS

Cardiogenic shock

The heart is unable to provide adequate perfusion to the body; MI, LHF, PE, dysrhythmias

Treatment for all shock

1. Provide basic life support- restore normal fluid volume composition and maintain adequate CO

2. Attach to cardiac monitor; Assess BP, HR, O2, LOC

3. Aggressively treat underlying cause of shock

Colloids

Draw water from the cells and tissues INTO the blood; Helps prevent leaking into the bloodstream

Crystalloids

Used to replace fluid lost and to promote UO; Can regularly leave the blood and enter the cells

Blood products

Given to restore blood volume and increase oxygen-carrying capacity

Priority treatment of shock

FLUIDS!!! (LR, albumin, blood); If ineffective, then go to medications

FALSE chemotherapy side effects

Fatigue

Alopecia

Low blood count

Stomatitis

Eating problems

Nadir

Lowest blood count; Resolves in 14 days

Neutropenia

Decreased neutrophil production

Leukopenia

Decreased overall WBC production

Bone marrow suppression

Decreased WBC, RBC, and platelet production

Absolute neutrophil count (ANC)

Identifies the risk for infection; ANC = WBC x neutrophils + bands (<1000 high risk, <500 very high risk)

Compromised host precautions

Private room, handwashing, no HCPS or visitors with infection, equipment in room, clean room daily, VS q 4 hrs, no urinary catheters, no gardening, no fresh produce, no harsh mouthwash

Thrombocytopenia

Decreased platelet production; Institute bleeding precautions and assess s/s of bleeding

Bleeding precautions

Lift sheet when repositioning, avoid venipuncture, electric razor, no rectal temps, no enemas *If inj necessary use sm gauge and hold firm pressure for 5-10 mins

Port-a-cath central line

Preferred IV access for chemotherapy administration

Vesicant

Medication that causes tissue damage

Extravasation

Leakage of vesicant drug into surrounding tissue

Alopecia

Hair loss- primary prevention cold cap and secondary interventions wig, head covering, cut long hair/shave early, avoid hair washing everyday, avoid hairdryers

Mucositis

Inflamed mucous membranes

Xerostomia

Dry oral membranes

Cell cycle

Chemotherapy can target different stages of the cell cycle

Adjuvant

Chemotherapy used after surgery to kill any cancer cells that might have been left behind

Neoadjuvant

Chemotherapy used before surgery to shrink a tumor

Targeted therapies

Targets specific genes or proteins to stop cancer growth

Metastases

Cancers that have spread