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3512 > week 9 Cancer > Flashcards

week 9 Cancer Flashcards

1
Q

what assessments are done to diagnose cancer?

A

health hx, family hx, physical exam, specific dx tests, and ultimately biopsy

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2
Q

two types of non-invasive (in situ) breast ca

A

ductal carcinoma
lobular carcinoma

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3
Q

is inflammatory breast cancer invasive or in-situ?

A

invasive

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4
Q

can ductal carcinoma be invasive?

A

yes- it breaks through the duct walls into surrounding breast tissue

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5
Q

which type of breast ca is rare but highly aggresive and characterized by diffuze erythema, and peau d’orange?

A

inflammatory breast ca

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6
Q

which of the following is NOT a risk factor for breast ca?
- age >65
- nulliparity or 1st child after 30
-oral contraception
- obesity
-alcohol
- smoking
- high socioeconomic status, jewish heritage

A

smoking not listed on slide

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7
Q

after what age do you have a mammogram every 2 years?

A

50

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8
Q

which type of breast surgery will require radiation post-surgery?

A

lumpectomy

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9
Q

with a sentinal node dissection, how many nodes are usually taken?

A

1-4

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10
Q

what is a DIEP flap?

A

when tissue is taken from lower abdomen and moveed up to reconstruct breast

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11
Q

post-op mastectomy: how long will drains be in place?

A

at least 5 days

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12
Q

what are three main nursing care priorities related to post-op mastectomy:

A

care for incisions and drains, control pain, restore arm mobility

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13
Q

what are some oral meds given as an adjunct with
mastectomy:

A

hormones, estrogen receptor blockers, biological and targeted therapy

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14
Q

post-op mastectomy: patients will be taught to care for these at home

A

drains

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15
Q

post-op mastectomy: what is the progression of drainage color?

A

red at first, then pink, then apple juice color

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16
Q

post-op mastectomy: criteria for drain removal?

A

removed after a couple weeks typically (when less than 30ccs in 24 hr period for 2-3 consecutive days)

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17
Q

Post Mastectomy: goals (name 3)

A
  • prevent contractures/muscle shortening
  • improve lymph and blood circulation
  • gradually increased function over 4-6 weeks
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18
Q

Post Mastectomy: nursing interventinos to restore arm mobility

A

-analgesics before exercise
- warm water compresses/soaks
-

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19
Q

Post Mastectomy: nursing interventions/teaching to prevent lymphedema

A

elevate arm, no elastic bandages post op, avoid sun and trauma, no BP or venipuncture, teach when problem becomes emergent

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20
Q

Post Mastectomy: nursing interventions to TREAT lymphedema when it occurs (4 ish categories)

A
  • massage/compression (neumatic or bandages) to move fluid
  • diuretics
  • isometric exercises
  • elevation
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21
Q

what parts of the body does leukemia affect?

A

bone marrow, lymph system and spleen

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22
Q

what is leukemia?

A

accumulation of dysfunctional blood cells in bone marrow and lack of production of normal ones

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23
Q

what are the results of leukemia?

A

thrombocytopenia, decreased WBC, decreased platelets

24
Q

5 organs/tissues that leukemia cells infiltrate typically

A

spleen, liver, lymph nodes, bones, meninges

25
Q

three phases of chemotherapy for leukemia

A
  • induction stage to achieve remission
  • consolidation phase
  • maintenence phase
26
Q

what percent of leukemia patients achieve remission with chemo?

A

70%

27
Q

describe nursing care priorities during induction stage of leukemia tx

A

focuses on neutropenia, thrombo-cytopenia, anemia

28
Q

what types of cells are given to treat pancytopenia in leukemia treatment? how are they aquired?

A

stem cells. harvested from donor, pt’s own, or identical twin

29
Q

which cells are most affected by chemotherapy treatments?

A

bone marrow-stem cells,
epithelial cells in GI
ova or testes
hair follicles

30
Q

many chemotherapy drugs are _____

A

vesicants

31
Q

compare the radioactivity of temporary to permanent radiation implants (internal radiation)

A

temporary have high radioactivity, permanent emit at a low level and pt can be discharged

32
Q

what are the three principles of radiation precautions

A

time, distance, shielding

33
Q

what labs should a nurse monitor during chemo and radiation treatment (regarding myelosuppression)

A

HGB, HCT

34
Q

what can a patient with neutropenia NOT have in the room? (2 things)

A

flowers and fruit

35
Q

what is the blood work to monitor if someone is having chemo and radiation to assess their risk for infection?

A

ANC - absolute neutrophil count

36
Q

if pt with low ANC is febrile, what happens?

A

we initiate Abx therapy immediately

37
Q

what drug can we give to treat neutropenia?

A

colony stimulating factor (filgrastim-neupogen)

38
Q

why can we not give ginger to someone with pancytopenia?

A

because it affects coagulation while they are lacking clotting factors

39
Q

because of TNF causing nausea/vomiting and diarrhea, we want to assess for _______ (r/t fluid), _______ (r/t ph), and monitor _____ during tx

A

dehydration, alkalosis, weight

40
Q

after chemo and radation, how long do we teach pts to avoid sun?

A

1 year

41
Q

a patient who is nearing the end of their cancer treatment is planning to spend a day at an outdoor pool. what will we tell them?

A

avoid direct sun or extreme heat
if pool is chlorinated, don’t go in to prevent desquamation or rash

42
Q

what should pt be taught about oral hygeine during treatment?

A

rinse with saline after each meal and before bed, soft toothbrush, small sips of water ++ to replace saliva

43
Q

loss of sensation to hands and feet
impaired gait and balance
orthostatic hypotension
Neuropathic pain
Erectile dysfunction
Loss of fine motor function (playing an instrument)
Loss of taste discrimination, constipation

what are these a result of?

A

chemo induced peripheral neuropathy (CIPN)

44
Q

How do we treat CIPN?

A

there are no known evidence-based interventions

45
Q

related to female sexuality, what would I teach a patient undergoing tx?

A

use lubrication and a vaginal dilator after radiation

46
Q

describe immunotherapy, monoclonal antibodies, endocrine therapy and targeted therapies

A

new cancer-treating drugs that can work directly on ca cells or utilize endogenous immunity to attck ca, or slow growth. pts often undergo clinical trials to test these

47
Q

BIG ONE!
what is SVC syndrome?

A

obstruction of superior vena cava by tumor, or blood clot in CVAD

48
Q

what are the signs of SVC (KNOW THIS!)

A

facial edema, periorbital edema, distention of neck and chest, headache, seizures, eventually obstruced airway and decfeased cardiac output

49
Q

how do we treat SVC syndrome?

A

radiation, chmo, surgery if its the tumor. remove the CVAD if that’s the problem

50
Q

besides SVC syndrom,e, what is an obstructive oncological emergency?

A

spinal cord compression

51
Q

if patient has constipation, bakc pain, and loss of reflexes, what might i suspect?

A

spinal cord compression

52
Q

what are three metabolic complications/emergencies of cancer?

A

SIADH, Hypercalcemia, tumor lysis syndrome

53
Q

what are the four hallmark signs of tumor lysis syndrome?

A

hyperuricemia
hyperphosphatemia
hyperkalemia
hypocalcemia

54
Q

patient has Hyperuricemia
Hyperphosphatemia
Hyperkalemia
Hypocalcemia
as a result of rapic destruction of tumor cells. what will i monitor and how will i treat?

A

monitor urine otput and urinary function labs. hydrate them and treat with allopurinal

55
Q

if a patient has bone cancer, what is a metabolic complication i am worried about? what is the worst case scenario if this goes untreated? how is this treated?

A

hypercalcemia,
coma
hydration, diuretic, biophospate infusion like Pamidronate

56
Q

what oncological emergency can occur when microorganisms enter the bloodstream from wounds, CVADs, etc?

A

easily leads to sepsis due to myelosuppression. septic shock leads to DIC, which leads to depletion of clotting factors (=bleeding) and clots (=organ damage)

57
Q
A

3512 (15 decks)

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