m2 Care of Patients with cancer & EOL

Pathophysiological markers of death

Cessation of integrated tissue/organ function, lack of heartbeat, and irreversible brain dysfunction.

Patient Self-Determination Act (PSDA) of 1991

Allows patients to determine medical care wanted or not wanted at end of life.

POLST

Physician Orders for Life-Sustaining Treatment.

Voluntary stopping of eating and drinking

An end-of-life choice that does not directly cause death.

Interventions for aspiration risk in dying patients

Raise the head of the bed (HOB) and manage dysphagia.

Preferred medication routes at end of life

Least invasive and most effective routes.

First steps in managing agitation and delirium

Assess for pain and urinary retention.

Palliative sedation

Lowering consciousness to manage refractory distress.

Presence in psychosocial care

Choosing to "be with" rather than simply "be there" for the patient.

Life review vs. Reminiscence

Life review reflects on life overall; reminiscence reflects on specific memories.

Physical signs of postmortem muscle relaxation

Loss of urine and stool, and the jaw falling open.

RN role in pronouncing death

An RN can pronounce death but cannot identify the cause of death.

Death certificate signatory

Must be signed by a medical practitioner.

Priority concept in cancer management

Immunity.

Interrelated concepts in cancer care

Cellular regulation, clotting, gas exchange, and sensory perception.

Radiation exposure vs. radiation dose

Exposure is radiation delivered; dose is radiation absorbed by tissue.

Adjuvant therapy

Chemotherapy combined with surgery or radiation.

Most important nursing intervention for extravasation

Prevention.

Required PPE for handling chemotherapy drugs or excreta

Eye protection, masks, double gloves (or chemo gloves), and gown.

Trastuzumab (Herceptin) key side effects

Skin reactions and adverse effects on the heart.

Bevacizumab (Avastin) key side effects

Hypertension, impaired wound healing, and bone marrow suppression.

Feminizing side effect of hormone therapy in men

Gynecomastia.

Oncologic emergencies

Sepsis, DIC, SIADH, spinal cord compression, hypercalcemia, SVC syndrome, and tumor lysis syndrome.

Greatest risk period for tumor lysis syndrome in acute leukemia

After the first cycle of chemotherapy.

Expected hair regrowth timeline after chemotherapy

Usually begins about 1 month after completion of chemotherapy.