NUR-3480 Exam 2: Gastrointestinal, Hepatobiliary, and Oncologic Disorders

Comprehensive vocabulary flashcards covering gastrointestinal disorders, hepatobiliary diseases, specific solid cancers, hematologic malignancies, antineoplastic pharmacology, and oncologic emergencies for NUR-3480 Exam 2.

Hepatitis A and E

Types of viral hepatitis transmitted through the fecal-oral route, typically via contaminated food or water.

Hepatitis B and C

Blood-borne viral hepatitis infections; Type B is transmitted via blood, sex, and birth, while Type C is transmitted primarily via blood, such as shared needles.

Fulminant Hepatitis

A severe, life-threatening complication of hepatitis characterized by acute, massive liver failure.

Cirrhosis

A chronic hepatic condition characterized by long-term liver damage progressing to scar tissue (fibrosis) and blood backing up into portal hypertension.

Hepatic Encephalopathy

A neurological complication of cirrhosis caused by elevated systemic ammonia levels, manifesting as confusion and flapping tremors (asterixis).

Lactulose

A laxative agent prescribed in cirrhosis to pull excess ammonia from the bloodstream into the stool, with a therapeutic goal of $2\text{--}3$ soft stools per day.

Esophageal Varices Bleeding

A critical emergency in cirrhosis caused by portal hypertension; signaled by vomiting blood (hematemesis) that requires immediate airway management and emergency assistance.

Cholecystitis

Inflammation of the gallbladder, typically caused by gallstones blocking the organ, presenting with right upper quadrant (RUQ) pain radiating to the right shoulder.

Murphy's Sign

A diagnostic indicator of acute cholecystitis in which the patient abruptly halts inspiration during deep palpation of the right upper quadrant (RUQ).

Pancreatitis

Inflammation of the pancreas occurring when digestive enzymes prematurely activate within the organ and autodigest pancreatic tissue; gallstones and alcohol are the most common causes.

Cullen's Sign

A clinical bleeding sign characterized by ecchymosis (bruising) around the umbilicus, indicative of retroperitoneal hemorrhage in pancreatitis.

Turner's Sign

A clinical bleeding sign characterized by ecchymosis (bruising) along the flanks, indicating severe hemorrhagic pancreatitis.

Gastroesophageal Reflux Disease (GERD)

A disorder caused by weakness or inappropriate relaxation of the lower esophageal sphincter (LES), allowing gastric acid to reflux back into the esophagus.

Proton Pump Inhibitors (PPIs)

Acid-suppressing agents (such as omeprazole and lansoprazole) that halt gastric acid production; must be administered $30\,\text{minutes}$ prior to meals.

Gastric Ulcers vs. Duodenal Ulcers

Gastric ulcers produce burning pain during or immediately with food intake and weight loss; duodenal ulcers cause pain $2\text{--}3\,\text{hours}$ after eating and pain that improves with food intake.

Sucralfate

A mucosal protective agent for peptic ulcer disease that adheres directly to the ulcer crater like a bandage; must be taken on an empty stomach.

Misoprostol

A synthetic prostaglandin analog that prevents NSAID-induced peptic ulcers; strictly contraindicated during pregnancy due to the risk of inducing uterine contractions.

Crohn's Disease

An inflammatory bowel disease characterized by transmural (full-thickness) inflammation occurring anywhere along the GI tract in patchy skip lesions, often leading to fistulas and strictures.

Ulcerative Colitis

An inflammatory bowel disease confined continuously to the mucosa and submucosa of the colon and rectum, presenting with bloody diarrhea with mucus and cramping abdominal pain.

Toxic Megacolon

A life-threatening complication of ulcerative colitis characterized by severe abdominal distension, fever, and tachycardia.

Celiac Disease

An autoimmune reaction triggered by gluten that results in small intestine villous atrophy and malabsorption; treated exclusively with a lifelong strict gluten-free diet avoiding wheat, barley, and rye.

McBurney's Point

The anatomical site located in the right lower quadrant (RLQ) that exhibits localized tenderness and rebound tenderness in acute appendicitis.

Appendiceal Perforation Sign

A critical danger sign in acute appendicitis where a patient's severe abdominal pain suddenly resolves, followed by rigid abdomen, high fever, and worsening pain.

Post-Mastectomy Arm Precautions

Essential nursing safety protocol prohibiting blood pressure checks, injections, and venipunctures on the ipsilateral arm to prevent secondary lymphedema.

Small Cell Lung Cancer (SCLC)

A highly aggressive, rapidly disseminating histological subtype of lung cancer strongly associated with smoking, in contrast to non-small cell lung cancer (NSCLC).

Gleason Score

A histological grading score obtained via biopsy to predict the aggressiveness and growth rate of prostate cancer, where higher scores signify more aggressive tumors.

Cryptorchidism

An undescended testicle; a major clinical risk factor for developing testicular cancer in young males aged $15\text{--}35$.

Healthy vs. Compromised Stoma Appearance

A normal intestinal stoma should be pink or red and moist; a stoma that appears dark, dusky, or black indicates ischemia/necrosis and requires immediate reporting.

Earliest Indicator of Increased ICP

A change in the patient's level of consciousness (LOC), which precedes focal deficits and vital sign changes in expanding intracranial brain tumors.

Philadelphia Chromosome

A specific genetic translocation characteristic of chronic myelogenous leukemia (CML) that serves as the therapeutic target for imatinib.

Reed-Sternberg Cells

Distinctive, giant, multinucleated abnormal lymphocytes identified on lymph node biopsy that confirm the diagnosis of Hodgkin lymphoma.

B Symptoms

A systemic symptom triad seen in lymphoma that includes fever, drenching night sweats, and unintentional weight loss.

Neutropenia

A myelosuppressive reduction in absolute neutrophil count (ANC) below $1{,}500$, categorized as severe when ANC falls under $500$.

Nadir

The expected point of lowest blood cell counts resulting from chemotherapy-induced bone marrow suppression, typically occurring $7\text{--}14\,\text{days}$ post-infusion.

Thrombocytopenia

A myelosuppressive reduction of blood platelets below $150{,}000$, reaching critical levels at less than $20{,}000$, requiring bleeding precautions and avoidance of IM injections or rectal temperatures.

Metoclopramide Extrapyramidal Symptoms

Neurological adverse reactions associated with metoclopramide administration, manifested by involuntary muscle contractions, restlessness (akathisia), stiffness, and abnormal movements.

Febrile Neutropenia

An oncologic emergency defined as a temperature of $100.4^\circ\text{F}$ or higher in a patient with an ANC under $500$, demanding immediate administration of broad-spectrum IV antibiotics.

Tumor Lysis Syndrome (TLS)

An oncologic metabolic emergency caused by rapid lysis of cancer cells, resulting in '3 up, 1 down' electrolyte derangements: hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia.

Allopurinol

A xanthine oxidase inhibitor administered along with aggressive hydration to prevent and treat hyperuricemia and acute kidney injury in tumor lysis syndrome.

Spinal Cord Compression

An oncologic emergency caused by spinal metastases encroaching on the cord; back pain is the earliest warning sign, requiring emergency reporting, high-dose corticosteroids, and radiation.

Superior Vena Cava (SVC) Syndrome

An oncologic emergency resulting from extrinsic tumor compression of the superior vena cava, producing facial and upper extremity edema and dyspnea.

SIADH in Oncology

An oncologic paraneoplastic emergency where excessive antidiuretic hormone secretion causes pathological water retention, dilutional hyponatremia, and confusion.

Cyclophosphamide

An alkylating antineoplastic agent whose primary toxicities include myelosuppression and hemorrhagic cystitis (bleeding bladder).

Mesna

A chemoprotective detoxifying agent given alongside hydration during cyclophosphamide therapy to protect the urothelium from hemorrhagic cystitis.

Leucovorin Rescue

A folinic acid rescue agent administered after high-dose methotrexate therapy to protect healthy cells from severe folate deficiency and bone marrow suppression.

Doxorubicin

An antitumor antibiotic antineoplastic agent known to cause cardiotoxicity and benign red-colored urine, requiring lifetime cumulative dosage ceilings and cardiac monitoring.

Plant Alkaloids (Vincristine, Paclitaxel)

Antineoplastic agents derived from plants that notably cause dose-limiting peripheral neuropathy (numbness, tingling) and require strict vesicant extravasation precautions.

Platinum Compounds (Cisplatin, Carboplatin)

Heavy metal antineoplastic agents with high risks of nephrotoxicity (kidney damage), ototoxicity (hearing impairment), and severe nausea, requiring aggressive IV hydration.

Trastuzumab

A targeted monoclonal antibody therapy directed against the human epidermal growth factor receptor 2 (HER2) in HER2-positive breast cancer.

TNM Staging System

A standardized clinical tumor staging metric evaluating primary Tumor size and extent (T), regional lymph Node involvement (N), and distant Metastasis (M).

Chemotherapy Excreta Precautions

Hazardous handling guidelines dictating that patient urine, stool, and vomitus remain biohazardous for $48\,\text{hours}$ following chemotherapy administration.

Palliative Care vs. Hospice Care

Palliative care provides symptom management and quality of life at any disease stage alongside curative therapies; hospice care is indicated when disease prognosis is $6\,\text{months}$ or less without curative intent.