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NCLEX > oncology > Flashcards

oncology Flashcards

1
Q

risk factors

A 
tobacco
alcohol + tobacco =cocarcinogenic
diet (low fiber, red meat, animal fat, nitrites, alcohol, preservatives and additives)
obesity
immunosuppressed 
aging
African Americans then whites
heredity
ultra violet radiation
carcinogens
stress
chronic irritations
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2
Q

primary prevention r/t cancer

A 
no smoking
exercise
good nutrition
normal body weight
alcohol limitation
vaccines
sunscreen
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3
Q

secondary prevention r/t cancer

A

breast self awareness
monthly breast self exams starting at age 20 on day 7-12 of menstrual cycle
yearly clinical breast exam over 40
age 20-39 clinical breast exam once every three years
mammogram at 40 annually
before mammogram avoid lotion, powder, and deodorant
pap age 21 every 3 years
colonoscopy at 5o every 10 years
fecal occult blood yearly at age 50

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4
Q

secondary prevention r/t cancer for males

A 
yearly clinical testicular exams
testicular tumors grow fast so monthly self exams 
digital rectal exam (PSA) over 50
colonoscopy at 50 and every 10 years 
fecal occult blood yearly at 50
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5
Q

tertiary prevention r/t cancer

A

manage long term care
support groups
rehab programs

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6
Q

general s/s

A 
CAUTION
change in bowel/bladder
a sore that wont heal
unusual bleeding/discharge
thickening or lump in breast or elsewhere
indigestion or difficulty swallowing
obvious change in wart or mole
nagging cough or hoarseness

invades bone marrow (anemia, leukopenia, thrombocytopenia)
unexplained weight loss (cachexia– extreme wasting and malnutrition)
fever (early sign of blood cancer and lymphoma)
fatigue
pain (bone, testicular, brain)

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7
Q

blood tests r/t cancer

A

abnormal CBC and diff (neutrophils)
elevated liver enzymes (AST/ALT)
tumor markers (biomarkers)

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8
Q

positive diagnostic studies

A 
chest xray
CT scan
MRI
PET scan
bone marrow biopsy
tissue biopsy
imaging studies
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9
Q

why is surgery used

A

prevention (benign)
diagnosis
treatment

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10
Q

total laryngectomy

A 
removal of vocal cords, epiglottis, and thyroid cartilage
permanent trach or laryngectomy
mid fowlers post op
NG feedings to protect suture line
monitor drains
frequent mouth care to decrease bacterial count 
humidified environment
use Blom-Singer device to talk
cannot whistle
cannot drink through a straw
can smoke but not recommended
cannot swim
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11
Q

reconstructive surgery

A

breast cancer common

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12
Q

post op mastectomy

A

bleeding- check dressings front and back (pooling of blood can occur)
abdominal sites can occur if they are using their own tissue
avoid procedures on arm of affected side if lymph nodes were removed (no constriction, no BPs, no blouses with elastic, no watch, no IV or injections, wear gloves when gardening, watch small cuts, no nail biting, and no sunburn)

brush hair, squeeze tennis ball, wall climbing, flex and extend elbow to promote circulation

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13
Q

internal radiation therapy

A

brachytherapy

used to get radiation close to tissue/cancer
inside the body
emits radiation for a period of time and is a hazard

sealed: emits radiation, body fluids not radioactive, temporary or permanent implant
unsealed: client and body fluids emit radiation, IV or PO, radioactive for 24-48 hours

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14
Q

precautions with internal radiation

A 
nursing assignments rotated daily
only care for one client with radiation in a given shift
private room
film badge at all times
restrict visitors
30 minutes/day for visitors
visitors must stay 6ft
no visitors less than 16 yo
no pregnant visitors/nurses
wear gloves
private room
cannot use same bed, toilet, or utensils as others
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15
Q

how to prevent dislodgment of the implant

A

bedrest
decrease fiber
prevent bladder distention

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16
Q

what if implant gets dislodged

A 
gloves
forceps to pick up the implant
place in lead-lined container
leave in room
call radiation department
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17
Q

external radition

A 
tele therapy
eternal beam radiotherapy
delivered outside of the body
not radioactive
SE: erythema, shedding of skin, fatigue, pancytopenia (all blood components are decreased) 
do not wash off markings
don't use lotion on markings
protect the skin from sun for 1 year after therapy
good skin care
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18
Q

action of chemo

A

eliminate or reduce cancer cells as they develop
specific chemo drugs– attack a specific phase of cell development
cell cycle non-specific: drugs that work on all or any phase of cell development
work best on cells actively growing

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19
Q

precautions for administration of chemo

A

oral
IM
topical
IV
intracavaity
look up drug info before administering
chemo gown-coated to prevent contamination-change immediately if contaminated
two pairs of chemo drugs (one under gown and one over the gown cuff)
wear goggles/mask if worried about splashing
excreted for 3-7 days after administration

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20
Q

disposal of chemo

A

yellow rigid chemo waste container for sharps and IV

yellow waste bag for gown, gloves, and disposable items

wash with soap and water after removing gloves

21
Q

manage chemo spills

A

hazard chemical spill

obtain spill kit and use all PPE for clean up

22
Q

major complication of chemo

A

extravasation

23
Q

patho of extravasation

A

given IV via central line
peripheral only if drug is push or infuses in less than an hour
a vesicant is a drug that if it infiltrates it will cause tissue necrosis

24
Q

s/s of extravasation

A

pain
swelling
no blood return

25
Q

treatment for extravasation

A

*** prevention
stop infusion and send for extravasation kit
stay with client

26
Q

transplants

A

used for hematologic cancers

27
Q

stem cell transplant

A

when stem cells are transplanted from the blood stream

given into a vein and settle in the bone marrow and produce healthy blood cells

28
Q

bone marrow transplant

A

stem cells transplanted from bone marrow

29
Q

GI r/t cancer

A 
N/V
antiemetic meds (Ondansetron) given routinely first week of chemo

stomatitis (oral cavity very susceptible to irritation)

diarrhea (nutrition and fluid and electrolyte imbalance)

30
Q

Ondansetron

A

blocks effects of serotonin (serotonin receptor antagonist)

all end in “ton”

31
Q

Netupitant/Palonosetron

A

oral combination antiemetic that prevents acute and delayed N/V
only 1 dose
one pill
one hour before chemo

32
Q

non pharm for N/V

A

ginger
aromatherapy
complimentary/alternative therapies (Acupuncture, acupressure, distraction, and relaxation)

33
Q

integumentary system r/t cancer

A

alopecia (hair loss)

huge sense of loss with mastectomy, amputation, or a scar that is a result of surgery

want them to look at the incision

34
Q

hematopoietic system (bone marrow) r/t cancer

A

causes decreased RBC, WBC, and platelets

at risk for anemia, infection, and bleeding

35
Q

general precautions to prevent infection

A 
private room
limit visitors
own supplies
change dressing and IV tubing daily
no gardening or cleaning of pets
cough and deep breath
avoid crowds
hand wash
drink only fresh water
avoid uncooked meat, seafood or eggs
brush teeth with soft toothbrush 4x/day
no alcohol based mouthwash
report high temo
36
Q

neutropenic precautions

A 
****also infection precautions
antibiotics
VS q 4hrs
private room w/ door closed
antimicrobial soap not regular soap
no invasive procedures (IM, rectal exam)
avoid catheters and NG tubes
limit tylenol
37
Q

fatigue r/t treatment

A

provide periods of rest
naps
limit visitation

38
Q

pain r/t treatment

A

without worry of dependence
can be from mucositis or peripheral neuropathy
use opioids
client dependent– no ceiling on the dose

39
Q

other therapies for pain management

A 
acupressure
accupuncture
cannabis 
distraction
hydrotherapy
massage
40
Q

neutropenia

A 
decreased neutrophils (mature WBCs) in the blood
calculate using ANC (absolute neutrophil count)

treatment: antibiotics and neutropenic precautions

41
Q

ANC normal

A

2500-8000 cells/mm

42
Q

DVTs

A

second leading cause of death in cancer clients

why?
bedrest
surgery
central line
external compression
invasion of vessels
chemo drugs

afraid of PE

43
Q

thrombocytopenia

A

decrease in circulating platelets in the blood
platelets are responsible for clotting
must have platelets to clot the blood to prevent bleeding

44
Q

risk factors for thrombocytopenia

A

advanced metastatic disease
hematological malignancies
bleeding disorders (hemophilia, liver disease, ITP)
bacterial infections
anticoagulant meds (aspirin, clopidogrel, heparin, warfarin)
result of cancer treatments

45
Q

thrombocytopenia assessment

A 
hx
VS
pulse ox
change in LOC, headache, pupil changes
conjunctival hemorrhages
petechiae, ecchymosis, purpura
oozing of blood
bleeding from rectum, ears, nose, or mouth
46
Q

treatment for thrombocytopenia

A

give platelets

47
Q

RBC transfusion

A

symptomatic anemia

dont want hgb/hct below 8 and 24%

48
Q

platelet transfusion

A

control/prevent bleeding with thrombocytopenia

NCLEX (17 decks)

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