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NCLEX > Oncology: 1 > Flashcards

Oncology: 1 Flashcards

1
Q

Cancer be classified by :

A
  • the tissue or blood cells where it starts

- the type

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2
Q

what are the 2 types of cancer?

A

Solid tumor and hematologic malignancies

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3
Q

Solid tumors arise from specific tissues.

types of solid tumors are:

A
  • sarcomas

- carcinomas

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4
Q

sarcomas

A

begin in the connective tissue, the tissues that the body uses to connect or support other tissue.

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5
Q

carcinomas

A

(most common type of cancer)
originates from the epithelial tissues, and this is the tissue that lines your organs.

these are the cancers that originate in the lining of the organs like the lungs and liver, the breast, colon or prostate.

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6
Q

hematologic malignancies:

A

orginate from blood and lymphatic cells.

  • cancer starts with one abnormal cell tha starts growing and dividng out of control
  • leukemia, lymphoma , etc
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7
Q

define metastasis

A

the “traveling” or extension of the primary cancer to other sites of the body

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8
Q

metastasis occurs by :

A
  • direct invasion
  • through the blood system
  • through the lymphatic system
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9
Q

What are the risk factors for cancer?

A
  • tobacco (#1 cause of preventable cancer)
  • alcohol + tobacco
  • dietary (low fiber, increased red meat, nitrates, increased animal fat, alcohol, preservatives and additives)
  • immunosuppressed
  • aging (higher incidence of cancer > age 60)
  • african americans
  • heredity
  • UV
  • carcinogens
  • stress
  • chronic irratation
  • previous history of other types of cancer or chemo
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10
Q

primary prevention:

A
  • No smoking
  • exercise and good nutrition
  • maintain normal body weight
  • limit or eliminate alcohol intake
  • vaccines for preventable viral exposures (hep b or HPV)
  • avoid exposure to known carcinogens
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11
Q

secondary prevention

A

(This is when we use screening to pick up on cancer early, when there is a greater chance for cure or control)

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12
Q

secondary prevention for females

A
  • breast self awareness is recommended
  • beginning in their 20s,women should be told about the benefits and limitations of monthly breast self exam (BSE)
  • yearly clinical breast exams for women greater than 40, women between 20-39 need one every 3 yrs.
  • mammogran-annually starting at age 40
  • pap smears beginning at age 21 and performed every 3 yrs if there have been no problems
  • colonoscopy at age 50, then every 10 yrs if there have been no problems.
  • testing the stool for fecal occult blood should be done yearly beginning at age 50, unless previous problems or a positive family history.
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13
Q

what day of the menstrual cycle are the best for doing self breast exam?

A

anytime from day 7 through day 12

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14
Q

post-menopausal or who have had hysterectomy should perform self-breast exam _____.

A

on the same say every month

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15
Q

before a mammogram what should you tell your client not to have on their body?

A

no lotion, no powder, no deodorant (can be picked up as calcium deposit)

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16
Q

secondary prevention for the male:

A
  • provide info on breast self-exam awareness and have yearly testicular exams
  • testicular tumors grow very fast, so many clinicians recommend monthly testicular self-exams
  • digital rectal exam and PSA (prostate specific antigen) may be checked annually for men over the age of 50.
  • colonoscopy at age 50 and then every 10 yrs and yearly fecal occult blood testing.
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17
Q

the major age group that gets testicular cancer is ____, between the age ____. teach TSE early

A

young men

15 and 36

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18
Q

tertiary prevention

A

focuses on the management of long term care for clients with complex treatments for cancer.

example: support group and rehab centers

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19
Q

General signs and symptoms of cancer:

A
  • CAUTION
  • anemia
  • unexplained weight loss
  • fever
  • fatigue
  • pain
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20
Q

define CAUTION

(Warning signs)

A 
C-change in bowel/bladder habits
A- sore that does not heel
U- unusual bleeding/discharge
T- thickening or lump in breast or elsewhere
I- indigestion or difficult swallowing 
O- obvious change in wart or mole
N- nagging cough or hoarseness
21
Q

cancer can invade the bone marrow which can lead to ____.

A

anemia, leukopenia (infection, thrombocytopenia (bleed)

22
Q

___ is another term what we hear used when we are studying cancer that mean extreme wasting and malnutrition.

A

cachexia

23
Q

what is the #1 symptom that clients complain of with a diagnosis of cancer?

A

fatigue

24
Q

what is an early sign for leukemia and lymphoma?

A

fever

25
Q

what is an early sign for brain , testicular, and bone cancer?

A

pain

26
Q

What are the blood test done to diagnose cancer?

A

-abnormal CBC and diff
( most concerned about neutrophils)
-elevated liver enzymes (AST and ALT)
-tumor markers

27
Q

positive diagnostic studies:

A
  • chest xray
  • ct scan
  • MRI
  • pet scan
  • bone marrow biopsy
  • tissue biopsy
  • imaging studies
  • bronchoscopy
  • sputum specimen
28
Q

A good example of a diagnostic procedure to diagnose lung cancer is a __.

A

bronchoscopy.

29
Q

What do you need to think about with the client who is having bronchscopy?

A
  • NPO pre and NPO until gag reflex returns

- watch for respiratory depression, hoarseness, dysphagia, and SQ emphysema

30
Q

Is it normal or abnormal to have respiratory depression when they come back from a bronchscopy?

A

ABNORMAL.

depressed less than 12/min

31
Q

When is the best time to get a sputum specimen?
is this specimen sterile?
do we use sterile or non sterile technique?
what should the client do first? why?

A

first thing in the morning
YES
STERILE
rinse mouth out with water because trying to decrease the bacteria count in the mouth.

32
Q

total laryngectomy

A

pt with head or neck cancer may have

-removal of vocal cords, epiglottis and thyroid cartilage.

33
Q

position post op of total laryngectomy?

A

mid fowlers 35-45 HOB

(will have permanent trach or laryngectomy, NG feedings to protect suture line, monitor drains, watch for carotid rupture, freq. mouth care)

34
Q

NPO people tend to get ____.

A

pneumonia

35
Q 
Suctioning:
hyper-oxygenate when?
sterile or non sterile technique?
when do you stop advancing the catheter?
apply suction when?
A

before and after
sterile
when you meet resistance or the client coughs
on the way out

36
Q 
Suctioning:
Intermittent or continuous suction?
suction no longer than \_\_
watch for arrhythmias
what nerve can be stimulated?
A

intermittent
10 sec
vagus

37
Q

when the vagus nerve is stimulated, the heart rate ___.

is this client hypoxic?

A

drops

NO

38
Q

with a total laryngectomy, all breathing is done through the ___.
how does the client talk?

A

stoma

they can use a electrolarynx, but the blom-singer device is the most common device that they use to talk.

39
Q 
Can the client with a total laryngectomy:
whistle?
drink through a straw?
smoke?
swim?
A

NO
NO
YES
No

40
Q

TNM system:

A

the staging classifies three characteristics:
T describes the size of the tumor
N describes if lymph nodes are involved
M is the presence of metasizes

41
Q

Disease grading:

  • grading compares the cancer cells with the parent cell they evolved from. the ___ cancer cells look like the tissue they originated from (their mom), the more ___ the cancer is.
  • grading is done on a ____ scale.
  • the higher the grade, the _____ the cancer
A

LESS
AGGRESIVE
1-4
Malignant

42
Q

Goals of treatment:

A

cure, control, palliation

43
Q

adjuvant means

A

when two therapies are used together

ex: chemo and radiation

44
Q

neoadjuvant means

A

time- specific therapies, or one before the next

ex: surgery then chemo

45
Q

the treatment plan will be based on the:

A

recommended treatment plans for the diagnosis
grade of cancer
what the client wants (keep the client involed!)

46
Q

surgery for cancer if for:

A

prevention
diagnosis
treatment
reconstruction

47
Q

___ is commonly used with breast cancer.

A

reconstruction

48
Q

if reconstruction using their own tissue is done, they will also have an _____.

A

abdominal surgical site

49
Q

Associated nursing care, if any lymph nodes were removed with the mastectomy:

A
  • avoid procedures on the arm of the affected side for the lifetime of the client (NO BP, constrictions, blouse with elastic,watch, iv or injections. wear gloves when gardening, watch small cuts, no nail biting and no sunburn)
  • brush hair, squeeze tennis ball, wall climb, flex and extend elbow WHY? promotes new circulation

NCLEX (14 decks)

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