Cancer

Question 1

What are the grades of cancer cells

Answer 1

Grade I – Cells differ slightly from normal cells and are well differentiated
Grade II – Cells are more abnormal and moderately differentiated
Grade III – Cells are very abnormal and poorly differentiated
Grade IV – Cells are immature, primitive and undifferentiated, cell of origin is difficult to determine
Grade X – Grade cannot be assessed

Question 2

What are the stages of cancer

Answer 2

Stage 0 – Cancer in situ
Stage I – localized tumor growth in origin area
Stage II – Limited local spread
Stage III – Extensive local and regional spread
Stage IV – Metastasis

Question 3

What are some neutropenic precautions

Answer 3

no flowers or fresh fruit
gown up
monitor for fever so take temp more often
separate room

Question 4

What might you need to do regarding platelets

Answer 4

platelet transfusion below 20k

Question 5

What is NADIR

Answer 5

your lowest immune cell count that you dont want to go below

Question 6

When does NADIR usu appear

Answer 6

7-10 days

Question 7

How does chemotherapy effect the GI sys

Answer 7

cells slough off causing dia, nausea/vom, pain from eating

Question 8

What is a complication of dia/N/V from chemo

Answer 8

dehydration
anorexia
nutritional deficit

Question 9

What meds are given for N/V from chemo and when do you give them

Answer 9

before they have symps
metoclopramide
ondansetron

Question 10

cons for dia and chemo

Answer 10

low fiber diets 
analgesic for anal area from rawness
monitor the amount with a catch device like a hat 
supplemental nutrition
may need extra IV fluids if gets too bad

Question 11

What are cons with mucositis

Answer 11

teach them stuff to coat their gums and tongue
soft brissel brush
them might lose taste

Question 12

What are cons with nutrition and why

Answer 12

more smaller meals instead of less larger ones bec of discomfort
may need TPN

Question 13

What are skin change cons with chemo

Answer 13

may have an allergic rx look

tx these like a normal burn

Question 14

What are some alopecia cons

Answer 14

emotional distress

sometimes perminent, sometime returns different color and tecture

Question 15

when will hair typically return

Answer 15

3-4 weeks after discon of meds

Question 16

What are lung and heart cons with chemo

Answer 16

pneumonitis 1-3mo after tx 
spontaneous Pulm edema causing cough and dyspnea 
pericardial effusion 
pericarditis 
damage to valves and coronary vessels

Question 17

What meds cause cardiotoxicity more oftn

Answer 17

Anthracyclines like. Adriamycin, daunorubicin

Question 18

What are cognitive and reproductive cons with chemo

Answer 18

damage to repro organs so preserve eggs and sperm

chemo brain may dev

Question 19

What test is important to monitor with pats taking chemo or rad

Answer 19

blood count

Question 20

What is the target blood count that providers want to get a pat to

Answer 20

NADIR

Question 21

because chemo and rad lowers blood counts, what precautions/problems do these pats need to be in

Answer 21

neutropenic
bleeding from thromcytopenia
anemia

Question 22

What vital sign would indicate an emergency for chemo/rad pats

Answer 22

high temp (fever)

Question 23

When would bleeding risk become high priority

Answer 23

platelet count below 50K

Question 24

What are some care cons for anemia and chemo rad pats

Answer 24

space out activities bec of fatigue

smaller more freq meal

Question 25

What should you do if the pats N/V didnt subside after the first use of a antiemetic

Answer 25

get new drug, dont continue using it bec its not going to work the second time

Question 26

What is some dia teaching for discharge pats

Answer 26

log poops, I/O and diet to monitor nutrition

Question 27

Do chemo rad pats have more freq dysphagia/odynophagia

Answer 27

yes

Question 28

What might be given if N/V isnt resolved with N/V meds,

Answer 28

IV drip called BAD
Benydryl
Ativan
Prednisone

Question 29

What is BAD’s regimen

Answer 29

slowly over 48 hours, decreasing the dose every 6 hours

Question 30

What is a skin reaction sydrome that can develop from chemo

Answer 30

erythrodysesthesia syndrome – also called palmar-plantar erythrodysesthesia

Question 31

What is erythrodysesthesia syndrome – also called palmar-plantar erythrodysesthesia

Answer 31

mild symps of redness and tingling in soel of feet and palms

Question 32

What are some is a care con for pats taking (Adriamycin), daunorubicin)

Answer 32

they will have routine echo’s done on their heart during and after tx