Stages of Plasma Cell Neoplasms
I would also recommend reading the book, so that you can fully address your issue s. You recommended starchy tubers instead of fibrous veggies — is it because their lower fiber content or bacause they are more nutritious? I feel like I have a good diet — I try to eat Paleo I usually only have veggies with dinner. Pyruvate dehydrogenase complex PDC deficiency PDCD is one of the most common neurodegenerative disorders associated with abnormal mitochondrial metabolism. Glycerol is a waste product in adipose tissues since without phosphorylation it cannot be utilized and the phosphorylating enzyme glycerol kinase is absent in adipose tissues.
General Information About Plasma Cell Neoplasms
Which statement can be inferred about amphibians? All amphibians are salamandridae, but not all salamandridae are amphibians. Some amphibians are vertebrates, but not all amphibians are vertebrates. Some salamandridae are amphibians, but not all amphibians are tetrapods.
All amphibians are vertebrates, but not all vertebrates are amphibians. What would this diagram be useful for? The chart is not specific to any particular disease. What type of bond between the complementary bases of DNA stabilizes the double helix structure?
Hydrogen bonds form between the bases to stabilize the double helix structure of DNA. Electrons exist as a cloud surrounding the nucleus and thus are not found inside it. Which of the following statements is true regarding trophic levels? Tertiary consumers acquire more energy content than secondary consumers.
Producers acquire less energy than primary consumers. Secondary consumers acquire more energy than primary consumers. Tertiary consumers acquire less energy than primary consumers. There is always a decrease in the amount of energy transferred from lower trophic levels to higher trophic levels. In general, the higher the trophic level of the consumer, the less overall available energy. Primary consumers have more energy available than both secondary and tertiary consumers.
Why does the human eye perceive a red colored dress as the color red? The molecules of the dress do not absorb red light wavelengths. The molecules of the dress absorb green and blue light wavelengths. A red dress will primarily absorb red light wavelengths.
A red dress will not absorb light wavelengths from non-red colors. When light hits an object, the object absorbs some of the light and reflects the rest of it. The wavelengths that are reflected determine how our eye perceives the color. A "dependent variable" represents the output or effect. Since the light is controlled by the experimenters, it is an independent variable.
Which organ system is primarily responsible for regulating metabolism, mood, and growth? The endocrine system is the collection of glands that regulate metabolism, growth and development, tissue function, sexual function, reproduction, sleep and mood, among other things. Vector components of an elephant are more complex than those of a penny. An elephant is not a projectile, while a penny is.
They both have an acceleration of 9. The elephant is greater in mass but is slowed less by the effects of air resistance. More massive objects will only free-fall faster than smaller objects if there is a significant amount of air resistance present. For a penny and an elephant that are free-falling in a vacuum, the rate of acceleration would be the same, so both would fall at the acceleration due to gravity which is 9. Which train described below would have the greatest momentum?
The momentum of an object is equal to the mass of the object times the velocity of the object. A scientist found that when an invasive species was introduced into a river, the population of salmon native to the region decreased. The type of correlation between these two populations could best be described as.
When one factor affects a second factor, it can be said that the two have a strong correlation. Since the salmon population decreases as the invasive species population increases, these two factors have an inverse relationship. The addition of a catalyst to a chemical reaction will have what effect? Increase the energy required for the reaction to take place.
Increase the time required for the reaction to take place. Increase the rate at which the reaction takes place. Reduce the amount of products in the reaction. A catalyst, by definition, is an enzyme that helps decrease the energy necessary to begin a reaction.
Consequently, the addition of a catalyst to a chemical reaction will increase the rate at which the reaction takes place. A reduction in the energy required to begin the reaction means that the reaction will take place more quickly. The pharynx is part of what body system? The pharynx is part of two systems; the respiratory and the digestive. It is another name for the throat, which extends from the base of the skull to the level of the sixth cervical vertebra.
Which of the following is true about eukaryotic cells? Unlike prokaryotic cells, eukaryotic cells contain mitochrondria, a nucleus, lysosomes, and multiple chromosomes. What characteristic of an element determines its specific isotope? The number of neutrons is what gives the element its specific isotope. The number of protons determines which element it is, while the number of electrons determines if the atomic particle has a positive, negative, or neutral charge.
Which of the following scenarios would NOT give a normal distribution? A distribution of the yearly income of families in the U. The distribution of heights in a large sample of people. The percentage of toxic wastes and pollution in the atmosphere vs. It is likely that as the percentage of toxic substances in an environment increases, the percentage of living organisms will decrease.
This would be an inverse relationship and would not exhibit a normal distribution. The rest would show normal distribution. In a cell, the Golgi apparatus is found in what location?
The Golgi body, or simply the Golgi, is an organelle found inside the cytoplasm inside a cell. While it is close to other organelles, it is positioned independently on its own within the cytoplasm. Which taxonomic rank is the next-smallest after Order? The taxonomy ranks run from largest to smallest: The next-smallest after Order is Family. Cytokinesis happens after telophase and it is the splitting of one cell into two.
In plants it involves the formation of a cell plate whereas in animals it involves the formation of a cleavage furrow. The information in DNA is stored as four nucleotides: The nucleotides adenine and guanine are classified as purines, while thymine and cytosine are classified as pyrmidines. Purines contain 2 carbon nitrogen ring bases and pyrimidines contain 1 carbon nitrogen base.
Which is NOT one of the four basic types of tissue? The parenchyma of an organ consists of that tissue which conducts the specific function of the organ and comprises the bulk of the organ. It is not one of the four basic types of tissue: Which of the following correctly completes the sentence above?
The stomach is above the small intestine. To calculate the atomic mass, we must sum the number of protons and the number of neutrons inside of the nucleus.
So, adding 42 protons with 37 neutrons results in an atomic mass of A patient who has suffered head trauma is not able to recognize people he has met around an hour earlier but is still able to recognize people he met before the injury. He most likely has damage to the: The hippocampus is the site of memory storage. The medulla oblongata is involved in involuntary controls, the corpus callosum is involved in connections between the two lobes and in emotions and the Pituitary gland is an endocrine organ..
What process is illustrated in the diagram above? Meiosis is a two-step process, and the four cells that result each have half the normal genetic material of the original cell.
Of the following, which is not a type of chemical bond? Ionic bonds involve the donation of and acceptance of electrons. Covalent bonds involve sharing electrons. Polar bonds describe electronegativity differences. Magnetic bonds are not chemical bonds. If the amount of hydrogen in a balloon of fixed size is doubled, what happens to the mass and density of the balloon? The mass increases, but the density decreases.
The mass decreases, but the density increases. As the number of molecules of air increases in a given volume, the mass of air also increases. As the mass of air in the given volume increases, its density also increases. For a chemical reaction to be balanced, the amount of reactants must be the same as the amount of products. Keep strict intake and output.
Encourage her to increase fluids. Your patient has a GI tract that is functioning, but has the inability to swallow foods.
Which is the preferred method of feeding for your patient? What is your priority? Auscultate to determine changes in bowel sounds. Observe the contour of the abdomen. Palpate the abdomen for a mass.
Percuss the abdomen to determine if fluid is present. Before bowel surgery, Lee is to administer enemas until clear. During administration, he complains of intestinal cramps. What do you do next?
Lower the height of the enema container. Complete the procedure as quickly as possible. Continue administration of the enema as ordered without making any adjustments. Leigh Ann is receiving pancrelipase Viokase for chronic pancreatitis. Which observation best indicates the treatment is effective? There is no skin breakdown. She loses more than 10 lbs. Stools are less fatty and decreased in frequency.
Ralph has a history of alcohol abuse and has acute pancreatitis. Which lab value is most likely to be elevated? Anna is 45 y. Despite multiple blood transfusions, her HGB is 7.
Her doctor determines that surgical intervention is necessary and she undergoes partial gastrectomy. Postoperative nursing care includes: Giving pain medication Q6H. Flushing the NG tube with sterile water. Keeping her NPO until the return of peristalsis. Sitty, a 66 y. She did well during the surgery and returned to your med-surg floor in stable condition. You assess her colostomy 2 days after surgery. Which finding do you report to the doctor?
Sharon has cirrhosis of the liver and develops ascites. What intervention is necessary to decrease the excessive accumulation of serous fluid in her peritoneal cavity? Increase sodium in the diet 4. Give antacids as prescribed.
Katrina is diagnosed with lactose intolerance. To avoid complications with lack of calcium in the diet, which food should be included in the diet? Milk and cheese products 4. Dark green, leafy vegetables. Nathaniel has severe pruritus due to having hepatitis B. What is the best intervention for his comfort? Avoid lotions and creams. Use hot water to increase vasodilation. Use cold water to decrease the itching. Which intervention will you include in his care?
Allow patient to select his meals. Rest period after small, frequent meals. Which statement suggests understanding by the patient?
Gail is scheduled for a cholecystectomy. Do you think this is a good idea? Encourage her to not worry about the future. Encourage her to express her feelings about the illness. Discuss the effects of hepatitis B on future health problems. Provide avenues for financial counseling if she expresses the need. Elmer is scheduled for a proctoscopy and has an I. The doctor wrote an order for 5mg of I. Which order is correct regarding diazepam? Give diazepam in the I.
Give diazepam rapidly I. Question the order because I. Which statement correctly describes a healthy stoma? A patient who underwent abdominal surgery now has a gaping incision due to delayed wound healing.
Which method is correct when you irrigate a gaping abdominal incision with sterile normal saline solution, using a piston syringe? Rapidly instill a stream of irrigating solution into the wound. Apply a wet-to-dry dressing to the wound after the irrigation. Moisten the area around the wound with normal saline solution after the irrigation.
Irrigate continuously until the solution becomes clear or all of the solution is used. Your patient recently had abdominal surgery and tells you that he feels a popping sensation in his incision during a coughing spell, followed by severe pain. You anticipate an evisceration. Which supplies should you take to his room? Sterile water and a suture kit. Sterile water and sterile dressings. Sterile saline solution and sterile dressings.
Findings during an endoscopic exam include a cobblestone appearance of the colon in your patient. The findings are characteristic of which disorder? Stomach pain is often a late symptom. Surgery is often a successful treatment. Chemotherapy and radiation are often successful treatments. The patient can survive for an extended time with TPN.
Dark, tarry stools indicate bleeding in which location of the GI tract? Controlling the bleeding source. Treating shock and diagnosing the bleeding source. Encouraging oral fluid intake. Monitoring central venous pressure. Monitoring laboratory test results and vital signs.
Giving blood, electrolyte and fluid replacement. What should your initial step be in working with this patient? Determine what the patient already knows about colostomies. Show the patient some pictures of colostomies. Arrange for someone who has a colostomy to visit the patient.
Provide the patient with written material about colostomy care. Your patient, Christopher, has a diagnosis of ulcerative colitis and has severe abdominal pain aggravated by movement, rebound tenderness, fever, nausea, and decreased urine output. This may indicate which complication? A patient has a severe exacerbation of ulcerative colitis. Long-term medications will probably include: The student nurse is teaching the family of a patient with liver failure. Gastric residuals have been ml when monitored Q4H.
You check the gastric residual and aspirate ml. What is your first response to this finding? Notify the doctor immediately. Stop the feeding, and clamp the NG tube.
Discard the ml, and clamp the NG tube. Give a prescribed GI stimulant such as metoclopramide Reglan. Your patient with peritonitis is NPO and complaining of thirst. Provide frequent mouth care. Give ice chips every 15 minutes. Kevin has a history of peptic ulcer disease and vomits coffee-ground emesis. What does this indicate?
He has fresh, active upper GI bleeding. He needs immediate saline gastric lavage. His gastric bleeding occurred 2 hours earlier. An NG tube is in place and is connected to low continuous suction. During the immediate postoperative period, you expect the gastric secretions to be which color? Your patient has a retractable gastric peptic ulcer and has had a gastric vagotomy.
Which factor increases as a result of vagotomy? Christina is receiving an enteral feeding that requires a concentration of 80 ml of supplement mixed with 20 ml of water. How much water do you mix with an 8 oz ml can of feeding? Which stoma would you expect a malodorous, enzyme-rich, caustic liquid output that is yellow, green, or brown?
George has a T tube in place after gallbladder surgery. Before discharge, what information or instructions should be given regarding the T tube drainage? Calcium carbonate Tums 2. The student nurse is participating in colorectal cancer-screening program. Which patient has the fewest risk factors for colon cancer? Janice, a 45 y. George, a 50 y. Herman, a 60 y. Sissy, a 72 y. His wound has ruptured and a small segment of the bowel is protruding.
Ask the patient what happened, call the doctor, and cover the area with a water-soaked bedsheet. Obtain vital signs, call the doctor, and obtain emergency orders. Blood pressure decreases as the body is unable to maintain normal oncotic pressure with liver failure, so patients with liver failure require close blood pressure monitoring. Good circulation causes tissues to be moist and red, so a healthy, well-healed stoma appears red and moist.
An ileoanal reservoir is created in two stages. The two surgeries are about 2 to 3 months apart. First, diseased intestines are removed and a temporary loop ileostomy is created. Second, the loop ileostomy is closed and stool goes to the reservoir and out through the anus.
Gradually, the small intestine absorbs more fluid and the output decreases. To avoid overloading the small intestine, encourage the patient to eat six small, regularly spaced meals.
Making observations about what you see or hear is a useful therapeutic technique. This way, you acknowledge that you are interested in what the patient is saying and feeling. After a Billroth II procedure, a large amount of hypertonic fluid enters the intestine. This causes extracellular fluid to move rapidly into the bowel, reducing circulating blood volume and producing vasomotor symptoms.
Vasomotor symptoms produced by dumping syndrome include dizziness and sweating, tachycardia, syncope, pallor, and palpitations. Ascites puts pressure on the diaphragm. Paracentesis is done to remove fluid and reducing pressure on the diaphragm. Cover the organs with a sterile, nonadherent dressing moistened with normal saline. Do this to prevent infection and to keep the organs from drying out. Asterixis is an early neurologic sign of hepatic encephalopathy elicited by asking the patient to hold her arms stretched out.
Asterixis is present if the hands rapidly extend and flex. Achalasia is characterized by incomplete relaxation of the LES, dilation of the lower esophagus , and a lack of esophageal peristalsis. Because nitrates relax the lower esophageal sphincter, expect to give Isordil orally or sublingually.
Eating in the upright position aids in emptying the esophagus. Doing the opposite of the other three also may be helpful. Pancreatitis involves activation of pancreatic enzymes, such as amylase and lipase. These levels are elevated in a patient with acute pancreatitis.
The normal range of specific gravity of urine is 1. Teach the pt to avoid activities that increase intra-abdominal pressure such as coughing, sneezing, or straining with a bowel movement. Because obesity weakens the abdominal muscles, advise weight loss for the patient who has had a hernia repair. After a liver biopsy, the patient is placed on the right side to compress the liver and to reduce the risk of bleeding or bile leakage.
Signs and Symptoms of pneumothorax include dyspnea and decreased or absent breath sounds over the affected lung right lung. Aspirating the stomach contents confirms correct placement. If an X-ray is ordered, it should be done immediately, not in 24 hours. TPN is given I. Increasing fluids helps empty the stomach.
One sign of acute diverticulitis is crampy lower left quadrant pain. A low-grade fever is another common sign. The gallbladder is located in the RUQ and a frequent sign of gallstones is pain radiating to the shoulder.
After creation of a colostomy, expect to see a stoma that is pink, slightly edematous, with some oozing. Bright red blood, regardless of amount, indicates bleeding and should be reported to the doctor. Measuring abdominal girth provides quantitative information about increases or decreases in the amount of distention. Because the GI tract is functioning, feeding methods involve the enteral route which bypasses the mouth but allows for a major portion of the GI tract to be used.
The first step in assessing the abdomen is to observe its shape and contour, then auscultate, palpate, and then percuss. Pancrelipase provides the exocrine pancreatic enzyme necessary for proper protein, fat, and carb digestion. With increased fat digestion and absorption, stools become less frequent and normal in appearance. After surgery, she remains NPO until peristaltic activity returns.
This decreases the risk for abdominal distention and obstruction. Restricting fluids decrease the amount of body fluid and the accumulation of fluid in the peritoneal space. Hepatitis B can recur. Patients who have had hepatitis are permanently barred from donating blood.
Alcohol is metabolized by the liver and should be avoided by those who have or had hepatitis B. To prevent venous stasis and improve muscle tone, circulation, and respiratory function, encourage her to move after surgery. Diazepam is absorbed by the plastic I. For the first few days to a week, slight bleeding normally occurs when the stoma is touched because the surgical site is still new.
She should report profuse bleeding immediately. To wash away tissue debris and drainage effectively, irrigate the wound until the solution becomes clear or all the solution is used.
Saline solution is isotonic, or close to body fluids in content, and is used along with sterile dressings to cover an eviscerated wound and keep it moist. Stomach pain is often a late sign of stomach cancer; outcomes are particularly poor when cancer reaches that point. Surgery, chemotherapy, and radiation have minimal positive effects. TPN may enhance the growth of cancer. Melena is the passage of dark, tarry stools that contain a large amount of digested blood.
It occurs with bleeding from the upper GI tract. A patient with an acute upper GI hemorrhage must be treated for hypovolemia and hemorrhagic shock. Controlling the bleeding may require surgery or intensive medical treatment. An inflammatory condition that affects the surface of the colon, ulcerative colitis causes friability and erosions with bleeding.
Patients with ulcerative colitis are at increased risk for bowel perforation, toxic megacolon, hemorrhage, cancer, and other anorectal and systemic complications.
Meats and beans are high-protein foods. In liver failure, the liver is unable to metabolize protein adequately, causing protein by-products to build up in the body rather than be excreted.
A gastric residual greater than 2 hours worth of feeding or ml is considered too high. The feeding should be stopped; NG tube clamped, and then allow time for the stomach to empty before additional feeding is added. Coffee-ground emesis occurs when there is upper GI bleeding that has undergone gastric digestion. For blood to appear as coffee-ground emesis, it would have to be digested for approximately 2 hours.
Normally, drainage is bloody for the first 24 hours after a partial gastrectomy; then it changes to brown-tinged and then to yellow or clear. If the vagus nerve is cut as it enters the stomach, gastric acid secretion is decreased, but intestinal motility is also decreased and gastric emptying is delayed.
Because gastric acids are decreased, gastric pH increases. As healing occurs from the bile duct, bile drains from the tube; the amount of bile should decrease.
Teach the patient to expect dark green drainage and to notify the doctor if drainage stops. Please log in again. The login page will open in a new window. After logging in you can close it and return to this page. About Privacy Disclaimer Contact. Cardiovascular Care Nursing Mnemonics and Tips. Elizabeth Wettlaufer Serial Murders: Did the System Fail the Patients?
Your answers are highlighted below. You expect the stoma to appear:. The stool from this colostomy is:. High-fiber foods stimulate peristalsis, and a result, flatus. Yogurt reduces gas formation. You tell the patient to measure and cut the wafer:.
Observation, percussion, palpation, auscultation.