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NURS 470 > Cancer > Flashcards

Cancer Flashcards

1
Q

3 stages of carcinogenesis and what happens in each stage

A
  1. initiation: mutation of cellular DNA
  2. promotion: growth of altered cells
  3. progression: tumor growth rate increases, metastasis occurs
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2
Q

What happens in cancer cells?

A

stem cells differentiate and lose functionality
lack of contact inhibition (keep growing)
continuous proliferation (doubling time and pyramid effect)
no apoptosis
oncogenes
altered cellular appearance

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3
Q

pyramid effect

A

doubling time of cancer tumor
exponential growth

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4
Q

Cancer warning signs (CAUTION)

A

Change in bowel/bladder habits
A sore that does not heal
Unusual bleeding/discharge from body orifices
Thickening or a lump in the breast/anywhere else
Indigestion or trouble swallowing
Obvious change in wart or mole
Nagging cough or hoarseness

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5
Q

primary prevention

A

decrease/eliminate exposure to carcinogens
healthy diet
exercise
alcohol in moderation
limit uv exposure (sun/tanning beds)

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6
Q

secondary prevention

A

inspection
palpation
screening

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7
Q

treatment modalities

A

surgery, chemotherapy, radiation, immunotherapy

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8
Q

goals of treatment

A

cure, control, palliation

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9
Q

how do we determine extent of cancer

A

histologic grading
staging

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10
Q

histologic grading

A

how similar cancer cells looks to cell of origin

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11
Q

staging

A

how advanced cancer is

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12
Q

lung cancer risk factors

A

smoking
pollution
radiation exposure
asbestos exposure
exposure to industrial agents
genetics: EGFR gene

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13
Q

early lung cancer manifestations

A

persistent cough, blood tinged sputum, dyspnea, wheezing, chest pain

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14
Q

late lung cancer manifestations

A

anorexia, fatigue, weight loss, SVC syndrome, pericardial effusion, dysphagia,

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15
Q

lung cancer diagnostic tests

A

CXR
CT scan
biopsy (sputum cytology, pleural fluid)
MRI, PET, bone scan, CBC, CMP

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16
Q

lung cancer treatment

A

surgical resection
radiation
chemotherapy
targeted therapy

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17
Q

colorectal cancer risk factors

A

diet: processed foods and meats
lifestyle: alcohol, smoking, inactivity
history of IBD: damaged cells
heredity

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18
Q

colorectal cancer manifestations

A

anemia r/t bleeding
rectal bleeding
abdominal pain
change in bowel habits
tenesmus: feeling like you have to poop but nothing comes out

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19
Q

colorectal cancer diagnostic studies

A

flexible sigmoidoscopy
colonoscopy
CEA
FOBT: fecal occult blood test

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20
Q

colorectal cancer treatment

A

surgery: resection, excision, colectomy
chemotherapy
targeted therapy
radiation

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21
Q

breast cancer risk factors

A

increasing age
ethnicity: african-american
long hormonal cycle exposure: early menarche & late menopause
pregnancy history: nulliparity & first child after 30
HRT >10yrs
benign breast disease combined w/ family history
family history 15-20% genetic + environmental
genetics: BRCA1, BRCA2, p53 tumor suppressor gene
hx of mantle radiation for HL
alcohol consumption, an increased dietary fat

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22
Q

breast cancer

A

skin changes, lumps, nipple discharge

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23
Q

metastatic disease

A

dyspnea, pain in back, confusion/altered LOC

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24
Q

breast cancer diagnostic tests

A

mammography
ultrasound
biopsy
HER2/hormone receptor status

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25
Q

breast cancer treatment

A

surgery: lumpectomy, mastectomy
radiation: external beam, brachytherapy, palliative
chemotherapy
hormonal therapy
triple negative breast cancer

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26
Q

Endometrial cancer risk factors

A

unopposed estrogen
age
nulliparity
obesity
smoking
diabetes

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27
Q

endometrial cancer clinical manifestations

A

abnormal uterine bleeding
pain

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28
Q

endometrial cancer diagnostic tests

A

biopsy
hormone receptor status

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29
Q

ovarian cancer risk factors

A

BRCA gene
nulliparity
early menarche, late menopause
obesity
family history
age

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30
Q

ovarian cancer clinical manifestations

A

vague symptoms
abdominal pain or bloating
changes to bowel or bladder
early satiety
weight loss or weight gain
menstrual changes

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31
Q

ovarian cancer diagnostic tests

A

no specific screening test
ultrasound
pelvic exam

32
Q

cervical cancer risk factors

A

exposure to HPV (types 16 and 18(
multiple sexual partners or partner with multiple sex partners
early age of first intercourse
smoking tobacco
low SES status
untreated chronic cervical infections
STDs

33
Q

cervical cancer clinical manifestations

A

dysplastic changes are asymptomatic
leukorrhea and bleeding
pain
bowel or bladder changes
weight loss
anemia

34
Q

cervical cancer diagnostic tests

A

pap smear
colposcopy
biopsy

35
Q

treatment of gynecologic cancers

A

radiation: external beam, brachytherapy
surgery: vaginal vs abdominal hysterectomy
chemotherapy
hormone therapy

36
Q

prostate cancer risk factors

A

age (increased)
ethnicity
family history
diet high in red meat and high fat, dairy, low vegetable intake
occupational exposure: fertilizer, textile, rubber industries

37
Q

prostate cancer clinical manifestations

A

asymptomatic in early stages
urinary changes
pain in lumbosacral area (metastasis)

38
Q

prostate cancer diagnostic tests

A

PSA testing
DRE
transrectal resection of prostate (biopsy)
MRI/CT

39
Q

prostate cancer treatment

A

active surveillance
radiation: external beam, brachytherapy
hormone therapy
chemotherapy (palliative)
surgery: radical prostatectomy (retropubic, perineal, laparoscopic, robot assisted), nerve sparing procedure
post surgical care: catheter 3 way foley, perineal care
complications: hemorrhage, DVT, PE, infection, ED, urinary incontinence

40
Q

oncologic side effects

A

bone marrow suppression(pancytopenia)
fatigue
GI: nausea, vomiting, diarrhea, mucositis, anorexia
integumentary: radiation, chemotherapy, alopecia, post surgical
reproductive
pain
respiratory, hepatic, renal toxicities

41
Q

oncologic emergencies

A

acute condition that is caused by cancer or its treatment, requiring rapid intervention to avoid death or severe permanent damage
structural, metabolic, infiltrative, or infectious

42
Q

in what cancers is superior vena cava syndrome seen?

A

non-hodgkins lymphoma, breast, lung, mediastinal mass

43
Q

superior vena cava syndrome symptoms

A

headache
facial/periorbital edema
vein distension in head/neck/chest

44
Q

superior vena cava syndrome treatment

A

radiation to reduce tumor size
thrombolytic
steroids

45
Q

superior vena cava syndrome nursing management

A

elevate HOB
O2
weights
ADLs

46
Q

what cancers is spinal cord compression seen?

A

breast, lung, prostate, GI, renal, melanoma

47
Q

spinal cord compression symptoms

A

change in bowel/bladder
intense pain in the back
motor dysfunction/weakness
change in sensation

48
Q

spinal cord compression treatments

A

MRI/CT
steroids
radiation
chemotherapy

49
Q

spinal cord compression nursing management

A

spinal precautions
pain management

50
Q

in what cancers is hypercalcemia seen?

A

multiple myeloma, advanced metastatic cancers (lung, breast, kidney, colon, ovarian, thyroid)

51
Q

hypercalcemia symptoms

A

apathy
confusion
depression
fatigue
ECG changes
muscle weakness
anorexia
nausea and vomiting

52
Q

hypercalcemia treatments

A

Ca greater than 12 mg/dL so IV fluids (hemodilution), biphosphonate therapy, diuretics

53
Q

hypercalcemia nursing management

A

safety precautions, monitor labs, increase mobility

54
Q

what cancers is SIADH seen in?

A

small cell lung cancer (SCLC), GI cancers, brain, esophagus, ovarian

55
Q

SIADH symptoms

A

weight gain
weakness
alteration in reflexes
confusion
oliguria
coma

56
Q

SIADH treatments

A

treat underlying cause
correct electrolytes
3% NaCl
fluid restriction

57
Q

SIADH nursing management

A

seizure precautions
safety management
education

58
Q

in what cancers is tumor lysis syndrome seen?

A

leukemia, lymphoma, bulky tumors

59
Q

tumor lysis syndrome symptoms

A

hyperuricemia
hyperkalemia
hyperphosphatemia
hypocalcemia
muscle cramps
nausea, vomiting
diarrhea
weakness

60
Q

tumor lysis syndrome treatments

A

allopurinol
treat electrolyte abnormalities
IV fluids

61
Q

tumor lysis syndrome nursing management

A

serial labs
education for patient

62
Q

in what cancers is DIC seen in?

A

leukemia, pancreatic, ovarian, lung, breast, prostate, sepsis/infection

63
Q

DIC symptoms

A

bleeding
petechiae
tachycardia
low SaO2
prolonged bleeding times (PT, PTT/INR)
decreased fibrinogen and platelets
increased d-dimer

64
Q

DIC treatments

A

treat underlying cause
FFP
possible heparin infusion

65
Q

DIC nursing management

A

bleeding precautions
supplemental O2

66
Q

When is sepsis seen?

A

indwelling lines, nadir, hematologic malignancies

67
Q

sepsis symptoms

A

hypotension
alteration in temperature
hi/low WBCs
chills
confusion

68
Q

sepsis treatments

A

IV abx
IV fluid
manage BP

69
Q

sepsis nursing management

A

frequent vital signs
protective precautions
patient education
CXR
ABG
labs

70
Q

how to provide support

A

provide resources
assess coping
maintain hope
RN relationship

71
Q

survivorship

A

starts from time of diagnosis
living with, through, and beyond cancer
3 stages: acute, extended, permanent

72
Q

Acute stage of survivorship

A

time of diagnosis through end of treatment

73
Q

Extended stage of survivorship

A

begins when patient starts to respond to treatment
fewer appointments with medical professionals
physical, emotional, psychologic side effects of treatment

74
Q

permanent stage of survivorship

A

late effects of disease/treatment
celebrate recovery

75
Q
A

NURS 470 (28 decks)

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