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《ISPN学习》总第556期
日期：2019-11-23 19:11:16
《ISPN学习》2019年11月08日总第556期
学习需要方法，但别人的方法不一定适合你，凡事皆然。
★ From the Programs ★
（From the Programs [课程选粹]栏目摘登奥医及国外NCLEX-RN（ISPN）课程视频讲座，旨在帮助读者了解NCLEX-RN（ISPN）考试内容，指导考生复习，加深考生对考试相关内容的学习、掌握[进一步了解请点击底部阅读原文]。您的需要就是我们的努力方向。
EKG Interpretation
| 想提高专业英语听力吗？想边练听力边增加护理专业知识吗？《Listening -- Elementary》(专业英语听力 – 初级)可助你一臂之力。 |
★ ISPN Review ★
Nursing Considerations for Patients Receiving Antimetabolites
抗代谢药物使用者的护理考虑
• Arrange for blood tests to monitor bone marrow function before, periodically during, and for at least 3 weeks after therapy to arrange to discontinue the drug or reduce the dose as needed.
用药前、用药期间定期及治疗后至少3周要安排血液试验，监测骨髓功能必要时安排停药或减少剂量。
• Administer medication according to the scheduled protocol and in combination with other drugs as indicated to improve the effectiveness of drug therapy.
根据预定治疗方案给药，根据指示与其他药物联用，增强药物疗法效果。
• Ensure that the patient is well hydrated to decrease the risk of renal toxicity.
确保病人水合充分，减少肾毒性风险。
• Provide small, frequent meals, frequent mouth care, and dietary consultation as appropriate to maintain nutrition when GI effects are severe. Anticipate the use of antiemetics as necessary.
GI效应严重时，应少量多餐，经常进行口腔护理，提供适当的营养咨询，以维持营养。认清使用抗代谢药物是必要的。
• Arrange for proper head covering at extremes of temperature if alopecia occurs; a wig, scarf, or hat is important for maintaining body temperature. If alopecia is an anticipated effect of drug therapy, advise the patient to obtain a wig or head covering before the condition occurs to promote self-esteem and a positive body image.
若出现脱发，应在极端气温时适当遮盖头部；假发、头巾、或帽子对维持体温很重要。若已预期药物疗法会引起脱发，建议患者在问题出现前就准备好假发或头部保护用品，增强自尊，维护正面体像。
• Protect the patient from exposure to infections because bone marrow suppression will limit immune/inflammatory responses.
保护患者，避免感染，因为骨髓抑制会限制免疫/炎症应答功能。
• Provide support and encouragement to help the patient cope with the diagnosis and the effects of drug therapy.
支持鼓励患者，帮助患者应对诊断和药物疗法影响。
• Instruct the patient to follow the appropriate dosage regimen, including dates to return for further doses.
指导患者遵循适当的给药方案，包括何时返院获得后续剂量。
• Remind patients to report all other drugs and alternative therapies that they might be using.
• Instruct patients to maintain nutrition if GI effects are severe.
提醒患者报告可能使用的其他所有药物和补充疗法。
指导患者出现严重GI问题时维持营养。
• Instruct patients to cover the head at extremes of temperature if alopecia is anticipated.
指导患者预期脱发时，在极端气温下保护头部。
• Instruct patients to plan for appropriate rest periods because fatigue and weakness are common effects of the drugs.
指导患者计划好适当的休息时间，因为疲劳和虚弱是药物的常见效应。
• Instruct patients to avoid situations that might lead to infection, including crowded places, sick people, and working in the soil.
指导患者避开可能导致感染的情况，包括人群拥挤场所、生病人群及田地劳作。
• Teach use of safety measures such as not driving or using dangerous equipment, due to possible dizziness, headache, and drowsiness.
鉴于可能的头晕、头痛及嗜睡，应进行安全装置使用教育，如驾驶或使用危险装备。
• Discusses alternative therapies often used by cancer patients that could interact with their drug regimen.
经常讲座患者使用的补充疗法，这些疗法可能与其药物疗法发生相互作用。
• Be aware of some potential interactions that may occur when alternative therapies are used, such as Echinacea, ginkgo, saw palmetto, St. John’s wort, etc.
应认识到，使用补充疗法时，可能出现某些潜在的相互作用，如紫锥花属、银杏、锯叶棕、圣约翰草等。
• Think about consulting with a health care provider, if appropriate, due to the possibility of impaired fertility.
• Use barrier contraceptives to reduce the risk of pregnancy during therapy.
适当考虑医疗保健人员咨询，因为可能出现生育障碍。
治疗期间，应使用屏障性避孕法，减少妊娠风险。
★ Vocabulary for Today ★
discontinue – n. 停用
protocol – n. 治疗方案
alopecia – n. 脱发
wig – n. 假发
scarf – n. 头巾
echinacea – n. 紫锥花属
ginkgo – n. 银杏
saw palmetto – n. 锯叶棕
St. John’s wort – n. 圣约翰草
Trexall – n. 特雷克斯
Pemetrexed – n. 培美曲塞
Alimta – n. 力比泰
pentostatin – n. 喷司他丁
Nipent – n. 喷司他丁粉针剂
thioguanine – n. 硫鸟嘌呤
Tabloid – n. 硫鸟嘌呤片剂
thymidylate synthetase – 胸苷酸合成酶
polymerase – n. 聚合酶
reductase – n. 还原酶
S phase – n. S阶段
leucovorin – n. 亚叶酸
isomer – n. 异构体
levoleucovorin – n. 左亚叶酸
| 尽快地从茫然中理清复习思路，准确地抓住复习重点，这是每一个考试复习者的一大愿望。“ISPN考试复习要点提示”即是帮您实现这一愿望的利器！该教程已在www.omedin.com陆续上线。 |
★ Video ★
Cancer tests
★ NCLEX-RN Experience ★
考试从来不易，前行者的经验可以使后来者少走不少弯路！
The NCLEX Exam: 7 Best Study Strategies
By Taylor Sienkiewicz
There are many different question types in the NCLEX, and some will be harder than others. Students studying for the NCLEX should not only review key content, but familiarize themselves with the question and answer format, as well as the overall structure of the test to prepare for the exam. There are several NCLEX study strategies that nurses who have taken the exam and Peterson’s test prep experts recommend.
1. Don’t wait too long after nursing school to take the test
2. Get in the minds of the test makers
The NCLEX can be tricky because you have to read the questions very carefully to ensure you’re actually answering the question.
“A lot of the answers that they give you [for multiple choice] are right, but they’re not necessarily the best answer or of the most priority. The study books that I used helped me use critical thinking and think about how the test makers write the test,” said Skov.
Finding the best answer involves analyzing the answer choices as well as the specific words used in the question. “NCLEX questions are written very specifically and there are sometimes indicators in the question that are kind of hidden, they give you a hint as to what the answers are, you just have to look very carefully at how the question is written, ” said Skov.
3. Work through practice questions and tests
What helped the most was that the test-taker did a lot of practice questions and practice tests. “When you do practice questions a lot, you start understanding what the test makers expect you to answer,” said Wolanska. Reviewing the content is helpful in re-establishing your base knowledge, but taking practice tests and answering test questions is what will really help you understand the test style and format.
4. Use your study guides, tests, and other materials from nursing school
Keep in mind that earning your nursing degree was largely preparation for the NCLEX, as the exam tests the knowledge you retained from your education.
5. Take a prep course if you can
Spending some time reviewing the base content in a focused way can help improve your quality of studying. This will allow you to develop a study base that you can continue using throughout your study period. “I would highly recommend taking a prep course to fully review every body system,” said Skov. If you don’t have the time or money to take a prep course, you can replicate some of these strategies on your own by coming up with ways to remember test topics.
6. Focus on tough question types
The NCLEX tests your knowledge in four major areas: safe effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity. However, the questions are presented in a random order as the exam is computer-administered. There are many standard multiple choice questions, but there are also different question types that you may find more difficult.
“A big thing that I worked hard on when studying was the “check all that apply” questions. Those questions are tough because you have to get the exact right answer. If you click one answer choice that is wrong, even if the other answers you chose were right, you get the whole answer wrong,” said Skov.
7. Pay attention to your timing and understand the structure
While you want to do your best when answering test questions, you don’t want to spend too much time on any one question. During your practice tests, dial in your pacing.
Keep in mind that you have approximately five hours to complete the exam, but the amount of questions you are given may vary.
“If you run out of time, don’t guess at answers. The NCSBN® recommends against guessing when pressed for time. Unlike paper-and-pencil tests in which guessing may help your score, guessing on a computer-adaptive test (CAT), such as the NCLEX-PN®, may actually lower your score.”
★ Test ★
1. The client with non-Hodgkin’s lymphoma is being managed with vincristine (Vincasar). Which of the following indicates a side effect specific to this medication?
A. Alopecia.
B. Numbness in the toes.
C. Chest heaviness.
D. Weight gain.
2. A client with a sarcoma is receiving Bleomycin (Blenoxane). The nurse in charge for the client expect the physician to order which diagnostic procedure?
A. Pulmonary function studies (PFT’s).
B. Stress test.
C. Cranial x-ray.
D. Electrocardiogram (ECG).
（答案见页底）
答案
1. B. Numbness in the toes.
A side effect specific to this medication is peripheral neuropathy. It can be manifested as numbness and tingling sensation in the finger and toes. Option A: Alopecia occurs nearly with all the neoplastic medications. Options C and D are not related to this medication.
2. A. Pulmonary function studies (PFT’s).
Bleomycin (Blenoxane) is an antitumor antibiotic that can cause interstitial pulmonary fibrosis. Pulmonary function tests and chest x-ray are done while on this treatment. Options B, C, and D are not related to the specific use of this medication.
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