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《ISPN学习》总第558期
日期：2019-11-23 19:17:46
《ISPN学习》2019年11月13日总第558期
学习就象护理病人，需要用心、专注，还需要耐心。
★ 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。
Ventricular arrhythmia
| 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 ★
MITOTIC INHIBITORS
有丝分裂抑制剂
Mitotic inhibitors are drugs that kill cells as the process of mitosis begins. These cell cycle–specific agents inhibit DNA synthesis. Like other antineoplastics, the main adverse effects of the mitotic inhibitors occur with cells that rapidly multiply: those in the bone marrow, GI tract, and skin. Mitotic inhibitors include Docetaxel (Taxotere), etoposide (Toposar, VePesid), ixabepilone (Ixempra), paclitaxel (Abraxane, Onxol, Taxol), Teniposide (Vumon), vinblastine (Velban), vincristine (Oncovin, Vincasar), and vinorelbine (Navelbine).
有丝分裂抑制剂杀死有丝分裂进程开始时的细胞。这些细胞周期特异性药物抑制DNA合成。与其他抗肿瘤药一样，有丝分裂抑制剂主要不良效应发生于繁殖迅速的细胞上：即骨髓、胃肠道和皮肤细胞。有丝分裂抑制剂包括多西他赛（泰索帝）、依托泊苷（拓扑杀、凡毕士）、伊沙匹隆（伊克森普拉）、紫杉醇（Abraxane、Onxol、泰素）、替尼泊苷（卫萌）、长春碱（硫酸长春碱）、长春新碱（安可平、Vincasar）和长春瑞滨（诺维本）。
Safe Medication Administration
Special care needs to be taken when administering these drugs. The nurse should avoid any skin, eye, or mucous membrane contact with the drug. This type of contact can cause serious reactions and toxicity.
安全用药
使用这些药物需要特别仔细，护士应避免任何皮肤、眼睛或粘膜接触这些药物，接触可能引起严重的反应和毒性。
Therapeutic Actions and Indications
The mitotic inhibitors interfere with the ability of a cell to divide; they block or alter DNA synthesis, thus causing cell death. They work in the M phase of the cell cycle. These drugs are used for the treatment of a variety of tumors and leukemias.
治疗作用和适应症
有丝分裂抑制剂干扰细胞分裂能力；阻断或改变DNA合成，从而引起细胞死亡。抑制剂在细胞周期M阶段发挥作用，用于治疗多种肿瘤和白血病。
Pharmacokinetics
Generally, these drugs are given intravenously because they are not well absorbed from the GI tract. They are metabolized in the liver and excreted primarily in the feces, making them safer for use in patients with renal impairment than the antineoplastics that are cleared through the kidney.
药动学
一般说来，这些药物为IV用药，因为这些药物GI吸收不佳。药物在肝代谢，主要经粪便排出，因此，与经肾清除的抗肿瘤药相比，这些药物用于肾损患者较为安全。
Contraindications and Cautions
These drugs should not be used during pregnancy or lactation because of the potential risk to the fetus or neonate. Use caution when giving these drugs to anyone with a known allergy to the drug or related drugs. Care is necessary for patients with the following conditions: bone marrow suppression, which is often the index for redosing and dosing levels; renal or hepatic dysfunction, which could interfere with the metabolism or excretion of these drugs and often indicates a need to change the dose; and known GI ulcerations or ulcerative diseases, which may be exacerbated by the effects of these drugs.
禁忌症与注意事项
妊娠或哺乳期不应使用这些药物，因为有潜在的胎儿或新生儿风险。已知该药或相关药物过敏者使用时就谨慎。有下列情况的患者必须小心使用：骨髓抑制，骨髓抑制常常是剂量调整的一个指标；肾或肝功能障碍，因为会影响这些药物的代谢或排泄，也常常是剂量调整的一个指标；已知有GI溃疡或溃疡性疾病，药物效应可能加重这些疾病。
★ Vocabulary for Today ★
mitotic – a. 有丝分裂的
mitotic inhibitors – 有丝分裂抑制剂
mitosis – n. 有丝分裂
Docetaxel – n. 多西他赛
Taxotere – n. 泰索帝
etoposide – n. 依托泊苷
Toposar – n. 拓扑杀
VePesid – n. 凡毕士
ixabepilone – n. 伊少匹隆
Ixempra – n. 伊克森普拉
paclitaxel – n. 紫杉醇
Abraxane – n. 注射用紫杉醇(白蛋白结合型)
Onxol – n. 紫杉醇注射液
Taxol – n. 泰素
teniposide – n. 替尼泊苷
Vumon – n. 卫萌
vinblastine – n. 长春碱
Velban – n. 硫酸长春碱制剂
vincristine – n. 长春新碱
Oncovin – n. 安可平
Vincasar – n. 长春新碱商品名
vinorelbine – n. 长春瑞滨
Navelbine – n. 诺维本
redosing level – n. 调整剂量水平
dosing levels – n. 剂量水平
| 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 ★
Mitotic Inhibitors
★ 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！
制定复习计划，参加合适的复习课程，这对很多NCLEX-RN考生来说，是非常有益的，也是迅速进入有序复习、避免茫然的有效途径。
Passing the Licensure Exam: An NCLEX Study Plan
Once nursing students finish their clinical rotations and courses and graduate from nursing school, one final hurdle looms between them and their first nursing job: the National Council Licensure Examination, commonly known as the NCLEX. With the right NCLEX study plan and test-taking strategies, you can go into the exam with the confidence that you’re ready to become a registered nurse.
1. Give yourself enough time to study
There isn’t a one-size-fits-all best time to take the NCLEX. Every nurse will have a different NCLEX success story. It’s a matter of finding the time that’s best for you. If your nursing program included a strong NCLEX review course, you might schedule your test just as you graduate. If yours didn’t, you might choose to take some extra weeks or months to study and review.
Considering those costs, you should give yourself plenty of time to study to ensure you’re ready to pass the first time you take it.
Your NCLEX study plan shouldn’t be unpleasant or rushed, but everything about it should be challenging, including the timeline. Give yourself the study hours you need.
We highly recommend allocating a specific amount of time each day and itemize the topics you need to cover during each session. Every student studies differently, but many nursing forums contain posts by past exam-takers with schedules that worked for them.
2. Implement your NCLEX study plan
One of the best ways to ensure that you ace the NCLEX is to take a few practice tests in preparation. The Internet has plenty of reputable resources when it comes to study guides and example NCLEX test questions. Once you have a nice collection of resources both online and in print, consider crafting a routine for your study days with a good balance of practice tests, reading materials, and enough downtime between to give you the brainpower you need to absorb the most possible information. Some test candidates like to study in intense, short bursts while others prefer to make studying an interwoven part of their everyday routines.
Whatever your NCLEX study plan may be, it can be wise to buddy up with a friend from your cohort who’s also preparing to take the exam. Although preparation is hard work, it can be rewarding — and even fun — to study with someone else. Even though you can’t take the test together, you’ll memorize more with two heads instead of one, and your individual strengths can help each other’s weaknesses.
Think of fun ways to study with a friend or group, like taking breaks to grab ice cream or planning to watch a favorite movie together after your study session. Building these sorts of rewards into your exam planning reinforces positive associations with the test material and keeps stress levels lower — which in turn means that information retention will go up.
3. Consider an NCLEX prep course
Some graduates might need a little extra oomph when they begin studying apart from their nursing instructors. The structured delivery of an NCLEX prep course can be helpful to those who struggle setting aside time to study between other activities. If you’re someone who learns better in a structured environment, there are many options for prep courses both online and in classrooms. NCLEX prep courses do cost a significant amount of money, yet for many students, the price is worth it for the assurance that a structured learning environment can bring.
Prep courses also serve as a fantastic option for the students who didn’t take or schedule the test immediately after graduation. If you are newly graduated from your nursing program, much of the material covered in the NCLEX may still be fresh in your brain. However, a prep course will help you bring the knowledge to the forefront of your mind if it’s been awhile since graduation. With a structured prep course, you can save yourself the time you would have spent sorting out study materials and old notes. Prep courses aren’t for everyone, but they can benefit a lot of nursing students.
★ Test ★
1. The client with a testicular cancer is being treated with Etoposide (Etopophos). Which of the following side effect is specifically associated with this medication?
A. Chest pain.
B. Edema.
C. Alopecia.
D. Orthostatic hypotension.
2. 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.
（答案见页底）
答案
1. D. Orthostatic hypotension.
While on etoposide infusion, blood pressure is monitored throughout and it should be administered slowly over 30-60 minutes to avoid hypotension. Options A and B are not related to this medication. Option C: Alopecia happens nearly with all the neoplastic medications.
2. 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.
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