Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 201 Week 2 > Cancer > Flashcards

Cancer Flashcards

(4)

1
Q

Normal cell growth is well controlled by ?

A

Cellular regulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cancer or malignant cells are (normal/abnormal), serve no normal function, and have quite a few features

A

abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  1. ? - is the change in appearance from the parent cell
  2. Have a larger nuclei-cytoplasmic ratio
  3. Serve no useful purpose
  4. Have loose adherence - do not make adhesion molecules; easily break off from the main tumor
A

Anaplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  1. Migration/metastasis
  2. Lack contact inhibition
  3. Rapid or continuous cell division - do not respond to apoptotic signals and have an unlimited lifespan (“immortal”)
  4. Abnormal chromosomes (chromosome # and/or structure is not normal [ ? ] )
A

aneuploidy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

?

Are substances that effect the genes of a normal cell and change it to a cancer cell

A

Carcinogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

?

Is the change in gene expression by anything that can penetrate and mutate the DNA of a cell. This process can overexpress cell division or damage the suppressor genes which limit division

A

Initiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

During progression, the cells continue to multiply and divide. They also develop their own blood supply (?)

A

angiogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A cluster of these cells create a primary tumor which arise from a parent tissue. This is also known as the tissue of origin and is used for classification

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Secondary tumors occur when cancer cells move from the primary location and establish remote colonies. This is also known as ___

A

metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

True or False?

If a primary breast cancer spreads to the ribs or spine, the secondary tumor is considered bone cancer

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Metastasis may spread by blood or the lymphatic system

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

True or False?

With grading, the cells that most resemble their parent tissue are most aggressive and considered “high-grade”

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

With ploidy, an increase in ___ usually increases the degree of malignancy

A

aneuploidy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

(TNM) stands for __, __, ___; describes the anatomic extent of cancers

A

tumor, node(s), metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A carcinogen can mutate a normal cell’s DNA and “switch off” the suppressor genes and allow ___-genes to overexpress and cause cancer

A

onco

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

True or False?

Cells that normally divide are at greater risk for cancer development

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Examples of Carcinogens

Chemicals
> Tobacco chemicals, charred red meat from a grill

Physical
> Burns, chronic irritation, radiation

Oncoviruses
> Hepatitis B and C, Epstein-Barr, HPV

A

Other factors that influence risk - immune function, increased age, and genetic predisposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Primary Prevention = ?

  • Using sunscreen
  • Smoking cessation
  • Using chemoprevention
  • Removal of at-risk tissues (i.e. colon polyps, pigmented skin lesions)
A

Avoidance (of known or potential carcinogens)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Secondary Prevention = ?

  • Mammography
  • Digital rectal exam (DRE)
  • Fecal occult blood testing
  • Checking for gene mutations (i.e. BRCA, colonoscopy)
A

Screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Secondary Prevention = ?

  • Mammography
  • Digital rectal exam (DRE)
  • Fecal occult blood testing
  • Checking for gene mutations (i.e. BRCA, colonoscopy)
A

Screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Some consequences of cancerous invasion

Hematological effects - marrow invasion or chemotherapy side effects

WBC - decrease production/function: increase risk of infection

RBC - decrease production/function: anemia, decreased O2 carrying capacity and fatigue

A

Platelets - decreased production: impaired clotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

GI effects

↑ metabolic requirements

↓ appetite, absorption

↑ risk of obstruction = cachexia and catabolism

A

Motor/sensory

  • Compression/invasion of motor nerves and/or skeletal system may effect movement and gait. Compression of sensory nerves may affect sensation and cause paresthesia or pain. Brain involvement may effect cognition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Reduced gas exchange

  • Compression/rupture of blood vessels and lung tissue
A

Management - Surgery types

  • Prophylactic
  • Palliative
  • Curative
  • Reconstructive
  • Biopsy/diagnostic
  • Cytoreductive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

?

Removal of a precancerous polyp

A

Prophylactic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

?

Offers confirmation of cancer

A

Biopsy/diagnostic

26
Q

?

Removal of tumor obstructing the intestine to improve quality of life; not a cure

A

Palliative

27
Q

?

Complete removal of cancer tissue

A

Curative

28
Q

?

De-bulking a tumor to improve odds of cure

A

Cytoreductive

29
Q

?

Breast implants after mastectomy

A

Reconstructive

30
Q

List of a few anticipated post-op interventions…

Physical rehab - PT/OT/ST

Psychosocial - medications, mental health and support groups

Wound care - nursing promotes early mobility, pain management, prevention of infection; teaching patients to look at and touch wounds for acceptance

A
31
Q

True or False?

The side effects of localized radiation to an intestinal tumor are usually systemic. It is typical that a client’s hair on their head will fall out after treatment

A

False

32
Q

True or False?

Radiation therapy usually is given as a series of divided doses because of the varying responses of all cancer cells within the tumor

A

True

33
Q

___ or internal radiation therapy, is located within the patient and is a potential hazard to the healthcare worker; these include unsealed PO or IV isotopes or sealed seed implants

A

Brachytherapy

34
Q

?

Is radiation delivered from outside the patient; therefore, the patient is not radioactive and healthcare workers are not at risk for radioactivity

With this therapy, radiation beam patterns are determined based on the tumor location
Position-fixing devices/markings are implemented. Body molds and tattoos may be implemented. DO NOT remove temporary tattoos!

A

External beam or teletherapy

35
Q

10 items when caring for a patient with sealed radioactive implants

  1. Private room and bath
  2. Dosimeter film badge
  3. Lead shield barrier
  4. Signage - “Caution: Radioactive Material”
  5. Lead apron
A
  1. Keep the door closed to the room as much as possible
  2. Limiting visitors to 1 half-hour per day; visitors to stay at least 6 feet from the source
  3. Never touch radioactive source with bare hands. If dislodged, use long-handed forceps to retrieve it
  4. After source is removed, dispose of dressings and linens in the usual manner
  5. No pregnant nurses caring for these patients; no women who are pregnant or children <16

More distance between you and patient and less time exposure are your friends

36
Q

Side effects of radiation - note that many side effects for radiation are common with chemotherapy

Skin breakdown - desquamatization

A
37
Q

Mucositis/xerostomia/tooth decay/breakage/taste, dietary changes
Lozenges, saliva - substitutes, dental visits

A

Fatigue r/t bone marrow suppression or increased energy demands for healing
Exercise, sleep nutrition

38
Q

Nausea/vomiting
Antiemetics, nutrition, hydration

A

Proctitis with diarrhea

39
Q

Chemotherapy

Used when cancer has spread beyond a local site (systemic) and effects all cells in the body by mostly rapidly dividing cells

A
40
Q

___ is the time when bone marrow activity and WBC counts are lowest after chemotherapy

It is common to use combination therapy using differing drug categories with differing ___ based on total body surface area of the client

The intravenous route is the most common for chemotherapy and requires special training to administer

A

Nadir

41
Q

True or False?

Healthcare personnel who prepare and administer IV and PO chemotherapy medications need to wear PPE including double gloves

A

True

Chemo can be absorbed through the healthcare provider’s skin

42
Q

?

A new cancer that occurs in an individual as a result of previous treatment with radiation or chemotherapy

A

Secondary malignancy

43
Q

Infiltration of vesicants can cause ___ which occurs when a drug leaks into the surrounding tissues at the IV site. Intervention includes knowing the institution’s policies and procedures that are drug-specific.

Increasingly, implanted port or central line methods of infusion are used to minimize this risk

A

extravasation

44
Q

Hemorrhagic cystitis

Chemoprotectants for bladder (Mesna) and kidney (Amifostine)

A

Cardiac muscle damage

45
Q

Hemorrhagic cystitis

Chemoprotectants for bladder (Mesna) and kidney (Amifostine)

A

Cardiac muscle damage

46
Q

Myelosuppression

  • ↓ WBC increases risk for infection; managed with biologic response modifiers and growth factors to stimulate bone marrow

! Know prevention and care of infection (key points)

A

Often, neutropenic clients do not exhibit signs of infection and institution protocols are usually in line if there is suspected infection to draw cultures and start abx asap

Common medications: Filgrastim (Neupogen), Pegfilgrastim (Neulasta)

Temp >100°: HCP may initiate anti-infectives
- Teach importance of mouth care, washing axillary and perianal areas at least q12h

47
Q

↓ RBC = increase hypoxia and fatigue

  • Epoetin alfa (Epogen), darbepoetin alfa (Aranesp)
  • Transfusions, oxygen
A

↓ platelets (thrombocytopenia) = increase risk for bleeding

  • oprelvekin (Neumega) [risk of fluid retention]
  • Platelet transfusions
  • Bleeding with small trauma at 50,000 platelets/mm3
  • Spontaneous bleed at 20,000 platelets/mm3
  • Bleeding prevention strategies
48
Q

Prevention of Injury for the Patient With Thrombocytopenia

A

Preventing Injury or Bleeding

49
Q

Mucositis

  • Mouth care
  • May be dose-related
  • Prevention with cryotherapy
A

Alopecia

  • Cryotherapy is being studied in preventing this side effect
50
Q

Nausea and vomiting

  • 1 or more antiemetics may be given before, during, and after chemotherapy
A

Cognitive function

  • “chemo brain”
    > Chemo doesn’t usually cross the blood-brain barrier but may cause inflammation; the nurse provides cognitive training and rehabilitation resources
51
Q

Peripheral Neuropathy

  • Risk for injury
A
52
Q

Oncological Emergencies

Sepsis

?

Phenomena of increased clotting then decreased bleeding

A

Disseminated intravascular coagulation (DIC)

53
Q

?

Occurs due to increased fluid retention then dilution of potassium and electrolytes

A

Syndrome of inappropriate antidiuretic hormone (SIADH)

54
Q

?

Condition that involves pain, paralysis, impaired organ function
- Palliative corticosteroids and radiation; surgery

A

Spinal cord compression (SCC)

55
Q

?

Occurs when tumor secretes parathyroid hormone releasing calcium from the bones

Common manifestations: renal stones, bone pain, change in mental status, abdominal discomfort

A

Hypercalcemia

56
Q

Hypercalcemia - Treatments

  • Aggressive IV normal saline to dilute calcium (! assess pt for volume overload)
  • Loop diuretics to remove calcium from urine
  • Calcitonin, biphosphonates, oral glucocorticoids, dialysis
A
57
Q

?

Occurs when there is a blockage of venous return from the head, neck, and upper extremities

  • Facial edema, engorged blood vessels, erythema of upper trunk, SOB, stridor, decreased cardiac output, decreased BP, change in MS
A

Superior vena cava syndrome

58
Q

Palliative treatment

  • High dose radiation therapy to upper chest area for temporary release of airway obstruction
  • Metal stent placement in vena cava to relieve swelling
A
  • Chemo as only option for long-term control of cancer causing the compression
59
Q

?

Is a sign of effective treatment

Occurs when lysis releases potassium from the cells that can cause cardiac dysfunction. Uric acid crystals clog the kidneys and cause AKI

A

Tumor lysis syndrome (TLS)

60
Q
  • Treat with IV hydration, sodium polystyrene sulfonate (Kayexalate), glucose, and insulin to decrease potassium; allopurinol to decrease uric acid
A
  • Drink 3000 mL a day leading up to and during treatment to help prevent TLS
  • Antiemetic regimen d/t N/V >chemo and may not feel like drinking fluids
  • Monitor daily weights and serum electrolyte values

NUR 201 Week 2 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions