Cancer Flashcards

Question

Diagnosis of Cancer

Answer 1

Patients with suspected cancer undergo extensive testing to: Determine the presence and extent of cancer, Identify possible spread (metastasis) of disease or invasion of other body tissues, Evaluate the function of involved and uninvolved body systems and organs, Obtain tissue and cells for analysis, including evaluation of tumor stage and grade.

Answer 2

The nurse can help relieve fears and anxiety by explaining the: tests to be performed sensations likely to be experienced patient’s role in the test procedures During this time of diagnosis with cancer, the Nurse: Encourages the patient and family to voice their fears about the test results Supports the patient and family throughout the test period Reinforces and clarifies information conveyed by the physician

Answer 3

Determines the size of the tumor, the existence of local invasion, lymph node involvement, and distant metastasis. “TNM” system is frequently used. “T” refers to the extent of the primary tumor. “N” refers to lymph node involvement. “M” refers to the extent of metastasis.

Answer 4

Grade=histologic estimate of the degree of differentiation of a tumor Determined by a pathologist Looks for differentiation Stage=clinical extent of size and spread of tumor Determined clinically Size of primary lesion and presence or absence of metastases

Answer 5

-Grade I Tumors: Well-differentiated tumors Closely resemble the tissue of origin in structure and function. -Grade IV Tumors: Poorly differentiated or undifferentiated. Do not clearly resemble the tissue of origin in structure or function.

Answer 6

Local invasion - by most direct route or lines of least resistance such as naturally occurring tissue planes - ----Around nerve bundles, favored by prostatic cancers Lymphatic spread -Typical of carcinomas, especially breast cancer Seeding - local seeding, surgery Vascular spread - Favored path of sarcomas - Arteries less penetrated than veins Angiogenesis - Malignant cells have ability to induce growth of new capillaries from host tissue to meet needs for nutrients and oxygen. - Vascular network can allow tumor emboli to enter systemic circulation and travel to distant sites.

Answer 7

Solid Tumors- associated with organs from which they develop. Hematological cancers- originate from blood cell-forming tissues.

Answer 8

``` -By location Skin – squamous cell carcinoma Glands – adenocarcinoma Bone – osteosarcoma, Ewing’s sarcoma Brain – gliomas, astrocytoma, neuroblastoma Lung, breast, liver, pancreas,etc -Hematologic (cells, vessels) Leukemia, myeloma, lymphoma ```

Answer 9

- Detects development of malignant cells - Destroys malignant cells before they become uncontrolled - T-lymphs – type of white blood cell, part of immune system, fight infection and may fight cancer - Macrophages – defends, may favor tumor - B-lymphs- makes antibodies - NKs (natural killers) produce enzymes that assist in cell destruction

Answer 10

``` C- change in bowel or bladder habits A- a sore that does not heal U- unusual bleeding or discharge T- thickening or lump in breast or elsewhere I- indigestion or difficulty swallowing O- obvious change in wart or mole N- nagging cough or hoarseness ```

Answer 11

- Pap smears – start 21, 21-29 every 3 yrs, 30-65 every 5 yrs - Breast self exam –monthly - Mammograms-40-44, 45-54 every yr, 55 every 2 yrs, HX of breast cancer 25yr older - Stool for occult blood - prn - Colonoscopy – after 50yrs, every 10 yrs - Chest x-ray - prn - Prostate exams – 50yrs - Testicular self exam – monthly

Answer 12

``` Symptomology -Takes a lot of cell growth before s/s noted -s/s dependent on location and size -X-ray, CT, MRI, Bone Scans -Biopsy -Labs Tumor marker identification Genetic markers (Brca-1,2 for breast CA) PSA (Prostate CA) ```

Answer 13

Malignant # of immature leukocytes – sudden or chronic onset S/S– bleeding, anorexia, fatigue, wt loss Nursing – isolation, bleeding precautions (avoid IM Injections, avoid invasive procedures), monitor VS, temp, WBC, avoid raw fruits, vegs, plants, pepper, pad side rails, electric razors, count pads (menstruating)

Answer 14

Malignancy of lymph nodes that spreads S/S– fever, fatigue, night sweats, enlarged lymph nodes, anorexia, wt loss Nursing – monitor for s/s of chemo, radiation, monitor for s/s infection and bleeding, discuss possible sterility for male pt

Answer 15

Malignant amount of plasma cells and tumors within the bones S/S– bone pain (esp. pelvis, spine), fatigue, recurrent infections, osteoporosis Nursing – careful handling of pt in bed, monitor for s/s bleeding, fractures, force fluids, observe for s/s renal failure (too much calcium released from bone – clogs kidneys), pain control

Answer 16

Most often between 15-40 yrs Metathesis to lung, liver, bone, adrenals S/S– painless, testicular swelling, dragging sensation in scrotum, back or bone pain, Nursing – prepare for chemo, surgery, possible sterility, discuss sperm options (Sperm Banking)

Answer 17

Involves cervix and other pelvic structures S/S – painless vaginal bleeding, pelvic pain, vag. discharge, leakage of urine & feces from vag., dysuria, hematuria, enlarged uterus, abd. Swelling. Nursing – prepare for laser, cryo (watery discharge for several wks), conization, hysterectomy, or pelvic exenteration procedures (colostomy, ileal conduit)

Answer 18

Usually noted when mass felt in breast – spreads easily via lymph S/S – fixed, irregular, non-encapsulated usually painless mass until late stages, nipple discharge, dimpling (peau d’orange skin), swollen lymph nodes in axilla Nursing – elevate affected arm, no sticks, BP in arm, diuretics for lymphedema, Reach for Recovery

Answer 19

Malignant masses or polyps that lead to obstruction, abscess formation, and bleeding S/S – anorexia, wt. loss, N/V, indigestion, dysphagia, ascites, blood in stools, change in stools/pattern Nursing – monitor labs (CBC), prepare for surgery (NPO, NG Tube (do not irrigate or remove without order), observe for s/s obstruction, prepare for colostomy, ileostomy

Answer 20

May be primary or metastatic sites(Brain, lymph nodes, bones, liver, spine, adrenal gland). S/S – cough, dyspnea, hemoptysis, chest pain, anorexia, wt loss, weakness Nursing – semi-fowlers, assess breath/lung sounds & effort, prepare for surgery, chest tubes, oxygen, pulse ox,

Answer 21

Prostate – slow growing, men over 50 yrs S/S– asymptomatic in early stages, pea sized nodule on rectal exam, hematuria, urinary obstruction, pain down leg Bladder – growth from bladder wall spreads to pelvic structures, mets to lungs Nursing – TURP or prostatectomy, CBI, meds for spasms, monitor for blood loss, push fluids, prepare for ileal conduit, Kock pouch, self caths, monitor I&O, s/s UTI

Answer 22

``` Denial and isolation Anger Bargaining Depression Acceptance ```

Answer 23

The range of possible treatment goals may include: Cure complete eradication of malignant disease Control prolonged survival and containment of cancer cell growth Palliation relief of symptoms associated with the disease and improvement of quality of life ``` Surgery Radiation therapy Chemotherapy Hematopoietic stem cell transplantation(Bone Marrow) Hyperthermia Targeted therapies Combination of all and any type Unconventional therapy ```

Answer 24

In chemotherapy, antineoplastic agents are used in an attempt to destroy tumor cells by interfering with cellular functions including replication and DNA repair. Chemotherapy is used primarily to treat systemic disease rather than localized lesions that are amenable to surgery or radiation. Chemotherapy may be combined with surgery, radiation therapy, or both, to: reduce tumor size preoperatively, to destroy any remaining tumor cells postoperatively, or to treat some forms of leukemia or lymphoma.

Answer 25

Puncture, and leak-proof containers, IV bags Needleless systems Surgical N-95 respirator (respiratory & splash protection) Double layer of gloves (inner glove worn under gown cuff, outer glove worn over cuff) Long sleeve, disposable gowns Closed-system, puncture- and leak-proof containers labeled “hazardous: chemotherapy contaminated” for linens. Wash hands

Answer 26

Goal: destroy tumor cells, (cure, control, palliation) Drugs usually used in combination – to combat cell resistance Cancer trials – testing of new drugs -ethics Length of therapy depends on multiple factors; cellular response, pt’s tolerance Side effects depend on length, amount, frequency, pt’s health status prior, nutrition

Answer 27

-Rarely given via peripheral IV due to vascular damage and possibility of extravasations -Central lines -Implanted ports Very common, good for years if taken care of, requires special needle, insertion technique

Answer 28

- Alopecia - Nausea / vomiting / diarrhea - Loss of appetite - Weight loss - Stomatitis (now referred to as mucositis) - Increased risk for infection bone marrow suppression - Fluid and electrolyte imbalance - Bleeding disorders / anemias - Reproductive problems (ovulation, sterility) - Fatigue - Depression - Coping problems - Family disruption

Answer 29

Leading cause of death in cancer patients. Monitor lab studies to detect early changes in WBC counts. Assess common sites of infection frequently: pharynx, skin, perianal area, urinary tract, and respiratory tract. Typical signs of infection (swelling, redness, drainage, and pain) may not occur in immunosuppressed patients. Any temperature of 101°F or higher is reported and dealt with promptly. Cultures are obtained. Strict asepsis is essential! Exposure of the patient to others with active infections and to crowds is avoided. Patients may receive low-bacteria diets, avoiding fresh fruits and vegetables. Invasive procedures are avoided.

Answer 30

Gram-positive bacteria (Streptococcus and Staphylococcus species) and gram-negative organisms (Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa) are the most frequently isolated causes of infection. Fungal organisms, such as Candida albicans, also contribute to the incidence of serious infection. Viral infections are caused mostly by herpesviruses and respiratory viruses. Fever is probably the most significant sign of infection in immunocompromised patients.

Answer 31

Septic shock is often associated with overwhelming gram-negative bacterial infections. Nurse monitors blood pressure, pulse rate, respirations, and temperature every 15 to 30 minutes. ABGs and pulse oximetry are monitored to determine tissue oxygenation. Nurses administer IV fluids, blood products, and vasopressors as prescribed to maintain blood pressure and tissue perfusion. Broad-spectrum antibiotics may be prescribed to combat the underlying infection.

Answer 32

Assess the patient for factors that may contribute to bleeding: -Bone marrow suppression from radiation, chemotherapy, and other medications that interfere with platelet functioning (i.e. aspirin, heparin, warfarin, etc.). Common bleeding sites include: -Skin and mucous membranes; the intestinal, urinary, and respiratory tracts; and the brain. -Gross hemorrhage, as well as blood in the stools, urine, sputum or vomitus; oozing at infection sites; bruising; petechiae; and changes in mental status, are monitored and reported.

Answer 33

Bleeding and Hemorrhage: Thrombocytopenia (most common cause of bleeding in patients with cancer) is defined as a platelet count of less than 100,000/mm3. When platelet count decreases to between 20,000 – 50,000/mm3, the risk of bleeding increases. Platelet counts lower than 20,000/mm3 are associated with an increased risk for spontaneous bleeding (requires a platelet transfusion). Encourage patient to use a soft, not stiff, toothbrush and an electric, not straight-edged, razo

Answer 34

- Nurse avoids unnecessary invasive procedures (i.e. rectal temperatures, IM injections, catheterization). - Soft foods, increased fluid intake, and stool softeners. - Extremities are handled and moved gently to minimize the risk of spontaneous bleeding. - Monitor BP and pulse rates every 15 – 30 minutes. - Hemoglobin and hematocrit are monitored. - Nurse tests all urine, stool, and emesis for occult blood. - Nurse administers fluids and blood products as prescribed. - O2 may be needed

Answer 35

Relieving Pain: Although it is controllable, cancer pain is commonly irreversible and not quickly resolved. Adequate rest and sleep, diversion, mood elevation, empathy, and medications such as antidepressants, antianxiety agents, and analgesics enhance tolerance to pain

Answer 36

Nonopioid analgesics (i.e. acetaminophen) = mild pain Weak opioid analgesics (i.e. codeine) = moderate pain Strong opioid analgesics (i.e. morphine) = severe pain

Answer 37

Pain assessment scales are useful (FLACC for the nonverbal patient).

Answer 38

- Bone destruction - Obstruction of an organ - Compression of peripheral nerves - Infiltration/distention of tissue - inflammation/necrosis of tissue - Psychological, such as fear and anxiety

Answer 39

-Do not undermedicate a cancer patient!! -Pain management program -Start with mildest medications and increase as needed -Monitor for side effects and effectiveness of meds Also provide non-pharmacological methods

Answer 40

Most commonly reported side effect in patients who receive chemotherapy and radiation therapy. Patient may become less verbal and may appear pale, with relaxed facial musculature.

Answer 41

Assess the patient’s mood and emotional reaction to the results of diagnostic testing and prognosis and looks for evidence that the patient is progressing through the stages of grief.

Answer 42

Alternating periods of rest and activity are beneficial. Regular, light exercise may decrease fatigue and facilitate coping. Lack of physical activity and “too much rest” can actually contribute to deconditioning and associated fatigue.

Answer 43

-Disseminated intravascular coagulation (DIC) is a rare, life-threatening condition. In the early stages of the condition, DIC causes your blood to clot excessively. -Superior vena cava syndrome (SVCS), is a group of symptoms caused by obstruction of the superior vena cava ("SVC"), a short, wide vessel carrying circulating blood into the heart. -Cardiac tamponade occurs when the heart is squeezed by fluid that collects inside the sac that surrounds it. -Pleural effusions is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs. This excess fluid can impair breathing by limiting the expansion of the lungs -Spinal cord compression Spinal cord compression occurs when a mass places pressure on the cord. A mass can include a tumor or bone fragment. -Tumor lysis syndrome * a positive sign of effective treatment but leads to ↑ K+, ↑ uricemia which leads to kidney failure

Answer 44

Know the basics about cancer - options Know the common side effects of chemo and radiation therapy – that affect the patient and the nurse Be aware of resources for your patients and their family members If becoming an oncology nurse, take a chemo course

Answer 45

``` S/S: some symptoms may be vague and be present for awhile, others may start suddenly, depends on type of cancer Knowledge: patient’s current level, past history, readiness, stage of grief Financial resources: helps to make choices Family support: previous coping, availability ```

Answer 46

``` Knowledge deficit Pain Immobility / Self Care deficit Safety Nutrition / Fluid & electrolyte balance Body image Coping / Anxiety ```

Answer 47

``` Maintain nutritional balance Limit, reduce pain Accept diagnosis, prognosis Understand disease process Understand treatments Live with dignity ```

Answer 48

Involve pt and family in planning care Teach, teach, teach, explain….. meds, tx, Provide time, privacy, family interactions Provide resource, support group information Protect patient (immunosuppression) Follow protocols for chemo, radiation, etc. Skin and mouth care Monitor lab results – CBC, bleeding times Nutritional support Pain management IV site care Infection control / Isolation requirements Assessment of systems for changes

Answer 49

Special care must be taken whenever intravenous vesicant agents are administered. Vesicants are those agents that, if deposited into the subcutaneous tissue (extravasation), cause tissue necrosis and damage to underlying tendons, nerves, and blood vessels. Sloughing and ulceration of tissue may be so severe that skin grafting may be necessary. If extravasation is suspected, the medication administration is stopped immediately, and ice is applied to the site.

Answer 50

Antineoplastic drugs are often mutagenic, teratogenic, and carcinogenic. In addition, direct contact with the skin, eyes, and mucous membranes can result in local injury (and can increase cancer risk if enough drug is absorbed).

Answer 51

To minimize the risk of injury, IV administration should be performed only into a vein with good flow. Sites of previous irradiation should be avoided. If extravasation occurs, the infusion should be discontinued immediately

Answer 52

``` a class of drugs that causes tissue necrosis if deposited into subq tissue (adriamycin, nitrogen mustard, vincristine) To minimize the risk of injury, IV administration should be performed only into a vein with good flow. Sites of previous irradiation should be avoided. If extravasation occurs, the infusion should be discontinued immediately ```

Answer 53

ulceration – total extent of necrosis not known immediately, may involve tendons, muscles, bone

Answer 54

Careful monitoring of IV site (periph and central) Stop infusion immed. If s/s extrav., occur - redness, pain, swelling, inability to obtain blood return, sluggish flow of fluid Apply ice, (unless vinca alkaloid,(vincristine) and notify physician Have neutralizing agent (Na Bicarb is one) available for specific chemo drug

Answer 55

Monitor for side effects of drug Monitor labs **CBC, uric acid, electrolytes Contact physician for any untoward problems Encourage hydration and nutrition Administer other meds such as Benadryl, Zyloprim (Allopurinol) (to reduce serum uric acid) Follow safety guidelines when preparing meds **monitor IV sites frequently**

Answer 56

Targeted therapies seek to minimize the negative effects on healthy tissues by disrupting: specific cancer cell functions such as malignant transformation, communication pathways, processes for growth and metastasis, genetic coding. Mechanisms of action of targeted therapies include: - stimulation or augmentation of immune responses through the use of biologic response modifiers - targeting of cancer cell growth factors - promotion of apoptosis (programmed cell death) - genetic manipulation through gene therapy

Answer 57

Surgery as Primary Treatment: Goal is to remove - Entire tumor or as much as is feasible - Procedure sometimes called debulking Any involved surrounding tissue, including regional lymph nodes Local Excision: - Mass is small - Outpatient basis - Removal of mass and small margin of normal tissue that is easily accessible. Wide or Radical Excision: - Removal of the primary tumor, lymph nodes, adjacent involved structures, and surrounding tissues that may be at higher risk for tumor spread. - Considered if the tumor can be removed completely and the chances of cure or control are good. Prophylactic or Risk Reduction Surgery: Involves removing non-vital tissues or organs that are at increased risk of developing cancer. The following factors are considered when discussing possible prophylactic surgery: Family history and genetic predisposition; presence or absence of signs and symptoms; potential risks and benefits; ability to detect cancer at an early stage; alternative options for managing increased risk; patient’s acceptance of postoperative outcomes. Colectomy, mastectomy, and oophorectomy are examples.

Answer 58

Usually performed to obtain a tissue sample for analysis of cells suspected to be malignant. Biopsy is taken from the actual tumor, but in some situations, it is necessary to biopsy lymph nodes near the suspicious tumor.

Answer 59

When surgical cure is not possible, goals are to relieve symptoms, make the patient as comfortable as possible, and promote quality of life. Performed in an attempt to relieve symptoms, such as ulceration, obstruction, hemorrhage, pain, and malignant effusions.

Answer 60

May follow curative or extensive surgery in an attempt to improve function or obtain a more desirable cosmetic effect. Performed in one operation or in stages.

Answer 61

Approximately 60% of patients receive radiation at some point. Radiation may be used: To cure the cancer (i.e. thyroid carcinomas, localized cancers of the head and neck, and cancers of the cervix) To control malignant disease when a tumor cannot be removed surgically or when local nodal metastasis is present Prophylactically to prevent local recurrence or spread of microscopic cells Palliative radiation therapy is used to relieve the symptoms of metastatic disease or to treat oncologic emergencies. Goal of therapy – reduce size of tumor Types of therapy: internal & external Common side effects of radiation Skin irritations, n/v, weakness, depends on which body part/organ involved Destroys cancer cells with minimal damage to surrounding tissue by rads Nursing implications r/t radiation therapy

Answer 62

Internal: placement of “seeds” of radiation into body cavities or directly into certain organs (brachytherapy). Protocols for nursing care involve time in contact with the patient, distance between pt and nurse r/t time in room External: scheduled times to go to x-ray department & scheduled length of visits.

Answer 63

Seeds in direct contact with tumor cells Pt emits radiation during therapy (time varies) and is a danger to others Rads are eliminated via excreta – so pt is dangerous for up to 48 hrs Limit time of exposure to staff (< 30 mins), wear protective lead shield, no pregnant nurses, no children, limit visitors No sex for about 10 days post therapy

Answer 64

``` Recognized as the 4th cancer treatment Modify the relationship between the host and the tumor by altering the biologic response of the tumor cells. Hematopoieic growth factors (HGFs) Colony-stimulating factors (CSFs) Erythropoietin (EPO) Interferons, Interleukins ```

Answer 65

Used for treatment of cancer patients who initially respond to therapy then have a reoccurence. Types of transplants Allogeneic: marrow from a sibling or parent Syngeneic: marrow from an identical twin Autologous: marrow from the patient; harvested during remission, stored frozen & infused later **most common type Harvested by aspirations from iliac crest Given back to pt via IV central line (like blood) either IV push or over 30 mins Pt in danger of infection for up to 5 wks until marrow engrafts

Answer 66

Graft Verus Host Disease (GVHD) - the grafted cells are trying to attack the host cells = an unfortunate complication If marrow fails to engraft – death will follow unless another transplant is done and is successful

Answer 67

GI system: n/v, diarrhea, anorexia, stomatitis Hematopoetic system: bone marrow suppression, anemias Renal system: fluid & electrolyte imbalance due to increased demand on filtration and excretion of cell lysis products (esp. K++, calcium) Cardio-pulmonary system: CHF, cardiac ejection fraction changes, pulmonary fibrosis Reproductive system: sterility Pain Neurologic system: neuropathy

Answer 68

``` As a result of the underlying disease or various treatment modalities, patients with cancer may experience secondary problems such as: Reduced WBC counts Infection Bleeding Skin problems Nutritional problems Pain Fatigue Psychological stress ```

Answer 69

Stomatitis, refers to an inflammatory process of the mouth including the mucosa and tissues surrounding the teeth. Characterized by: Changes in sensation Mild erythema Edema If severe: Painful ulcerations Bleeding Secondary infection Commonly develops 5 – 14 days after patients receive certain chemotherapeutic agents. Tissues within mouth and gastrointestinal tract become ulcerated and susceptible to invasion, which can result in infection. Severe oral pain can significantly affect swallowing, nutritional intake, speech, quality of life, coping abilities, and willingness to adhere to treatment regimens. ``` Maintenance of good oral hygiene is necessary to minimize the risk of oral complications associated with cancer therapies: Brushing Flossing Rinsing Dental care ```

Answer 70

Palifermin (Kepivance), an IV administered synthetic form of human keratinocyte growth factor promotes epithelial cell repair and accelerated replacement of cells in the mouth and gastrointestinal tract.

Answer 71

Use soft-bristled toothbrushes and nonabrasive toothpaste. for 90 seconds after meals and at bedtime. Oral swabs with sponge-like applicators may be used in place of a toothbrush. Flossing may be performed unless it causes pain or unless platelet levels are less than 40,000/mm3. Oral rinses (saline solution or tap water) may be necessary for those who can’t tolerate tooth brushing (every 1 – 4 hours). Products that irritate oral tissues or impair healing (i.e. alcohol-based mouth rinses) are avoided. Avoid foods that are difficult to chew or are hot or spicy. Lips are lubricated. Adequate fluid and food intake is encouraged. Parenteral hydration and nutrition may be necessary (depending on severity of stomatitis). Remove dentures (only use them for eating)

Answer 72

Avoid the use of soaps, cosmetics, perfumes, powders, lotions, and ointments; non-aluminum-based deodorant may be used on intact skin. Use only lukewarm water to bathe the area. Avoid rubbing or scratching area. Avoid shaving the area with a straight-edged razor. Avoid applying hot-water bottles, heating pads, ice, and adhesive tape to the area. Avoid exposing the area to sunlight or cold weather. Avoid tight clothing. - Use cotton clothing. Apply vitamin A and D ointment.

Answer 73

Temporary or permanent thinning or complete loss of hair is a potential adverse effect of whole brain radiation therapy and various chemotherapeutic agents. Usually begins 2 – 3 weeks after initiation of treatment. Regrowth most often begins within 8 weeks after the last treatment. For many patients, hair loss is a major assault on body image. Hair loss can serve as a constant reminder of the challenges cancer places on their coping abilities, interpersonal relationships, and sexuality. Assist patient in selecting and using cosmetics, scarves, hair pieces, hats, and clothing that increase his or her sense of attractiveness. Patient is encouraged to acquire a wig or a hairpiece before hair loss occurs so that the replacement matches the patient’s own hair.

Answer 74

Use of attractive scarves and hats may make the patient feel less conspicuous. Knowledge that hair usually begins to regrow after therapy is completed may comfort some patients. Color and texture of new hair may be different.

Answer 75

Most patients with cancer experience some weight loss during their illness. Common Nutritional Problems: Anorexia, malabsorption, and cancer-related anorexia-cachexia syndrome (CACS). Causes of anorexia in patients with cancer: Alterations in taste, manifested by increased salty, sour, and metallic taste sensations, and altered responses to sweet and bitter flavors. Anorexia may occur because patients develop early satiety after eating only a small amount of food. Psychological distress throughout illness may also have a negative impact on appetite. Patients may develop an aversion to food because of nausea and vomiting associated with treatment. Chemotherapy and radiation associated with mucositis cause damage to mucosal cells of the bowel, resulting in impaired nutrient absorption

Answer 76

- Continued weight loss and malnutrition characterized by loss of adipose tissue, visceral protein, and skeletal muscle mass. - Patient complains of loss of appetite, early satiety, and fatigue. - 50 – 75% of patients experience some degree cachexia.

Answer 77

Food should be prepared in ways that make it appealing. Small, frequent meals are provided, with supplements between meals Patients often tolerate large amounts of food earlier in the day rather than later. Patient should avoid drinking fluids while eating (to avoid early satiety). Oral hygiene before mealtime often makes meals more pleasant. If adequate nutrition can’t be maintained by oral intake, nutritional support via the enteral route (NG tube, gastrostomy, or jejunostomy) may be necessary.

Cancer Flashcards

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