Transcript
Cancer w5
Exercise 2 - Virtual Hospital Activity
Sign in to work at Pacific View Regional Hospital for Period of Care 1. (Note: If you are already in the virtual hospital from a previous exercise, click on Leave the Floor and then on Restart the Program to get the sign-in window.)
From the Patient List, select Pablo Rodriguez (Room 405).
Click on Go to Nurses’ Station.
Click on Chart and then on 405 for Pablo Rodriguez’s chart.
Click on History and Physical.
Exercise 2 - Question 1
What is Pablo Rodriguez’s main diagnosis?
Your Answer:
Advanced metastatic non–small cell lung carcinoma
Advanced metastatic non-small cell lung cancer
Question 2
Not yet graded / 1 pts
Exercise 2 - Question 2
How long ago was he diagnosed?
Your Answer:
Dagnosed 1 year ago
1 year ago
Question 3
Not yet graded / 1 pts
Exercise 2 - Question 3
What risk factor for lung cancer is documented on the History and Physical?
Your Answer:
Past medical history: History of 60-pack-years of smoking.
60 pack-years of smoking
Question 4
Not yet graded / 1 pts
Exercise 2 - Question 4
What are other risk factors for lung cancer?
Your Answer:
Approximately 90 percent of lung cancers are caused by cigarette smoking. Additional risk factors for lung cancer include secondhand smoking, a family history of lung cancer, some vitamins and exposure to chemicals like radon and asbestos.
Chronic exposure to asbestos, beryllium, chromium, coal distillates, cobalt, iron oxide, mustard gas, petroleum distillates, radiation, tar, nickel, and uranium. Air pollution that contains benzopyrenes and hydrocarbons.
Question 5
Not yet graded / 1 pts
Exercise 2 - Question 5
What clinical manifestations documented in the physician’s review of systems are related to the disease process of lung cancer?
Your Answer:
Breathing shallow & rapid; diminished breath sounds in upper left lobes, some crackles bilaterally. Multiple subcutaneous nodules on left upper chest anteriorly and on the back, left flank, left subchondral region, left hip, and left calf. Several nodules with pustules and oozing.
Shortness of breath, hemoptysis with sputum
Multiple nodules painful to touch (metastasis)
Question 6
Not yet graded / 1 pts
Exercise 2 - Question 6
What treatment has Pablo Rodriguez received so far?
Your Answer:
Patient underwent chemotherapy. After 6 months he underwent radiation therapy for 6 weeks, with a total dose of 63 Gy in 34 fractions, which also included supraclavicular fields in 27 fractions. The patient was then treated with docetaxel and oblimersen sodium. The last dose was 1 month ago.
6 months of chemotherapy followed by 6 weeks of radiation therapy; after radiation therapy he began receiving docetaxel and oblimersen sodium.
Question 7
Not yet graded / 1 pts
Exercise 2 - Question 7
How long ago did Pablo Rodriguez receive his last chemotherapy?
Your Answer:
The last dose was 1 month ago.
1 month ago
Question 8
Not yet graded / 1 pts
Click on Emergency Department. Scroll down to review the Emergency Department physician's progress notes for Tue at 1800.
Exercise 2 - Question 8
The Emergency Department physician notes that Pablo Rodriguez had a chest x-ray and bronchoscopy 1 year ago. Which type of cancer were the findings of the bronchoscopy consistent with? Is this the same type of cancer as was noted by the admitting physician in the History and Physical?
Your Answer:
The patient is suffering from advanced non-small cell carcinoma diagnosed one year ago when the patient presented with chief complaints of shortness of breath upon exertion. At that time the patient received a chest x-ray and underwent bronchoscopy, which was positive for carcinoma consistent with adenocarcinoma.
The Emergency Department physician's notes state that findings of Pablo Rodriguez's bronchoscopy were consistent with adenocarcinoma. The admitting physician noted that Pablo Rodriguez has NSCLC. Adenocarcinoma is one of three different types of lung cancer now referred to as NSCLC because of their similar response to treatment.
Quiz Score: 0 out of 8
