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Care and Management > Cancer Part 2: Specific Cancer Disorders > Flashcards

Cancer Part 2: Specific Cancer Disorders Flashcards

1
Q

Pathophysiology of Skin Cancer

A

caused by uncontrolled growth of abnormal cells in a specific epithelial cells of skin (squamous, basal, melanocytes)

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2
Q

risk factors for skin cancer

A
  • exposure to UV rays
  • Fair complain
  • Age
  • Male gender
  • Family Hx
  • Chemical exposures
  • Radiation exposure
  • upper elevations for close to the equator
  • presence of many moles
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3
Q

Basal Cell Carcinoma

A
  • most common form
  • usually painless and slow growing
  • sun exposed areas- head, face, neck
  • common in nodular lesson
  • rarely mestastasizes but can cause local tissue destruction
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4
Q

Squamous Cell Carcinoma

A
  • Firn, crusty or ulcerated
  • affects sun exposed area (head, neck, lower lip)
  • chronic irritation
  • rapid invasion
  • large tumors are likely to metastasize
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5
Q

malignant melanoma

A
  • deadliest form of skin cancer
  • irregular, red, blue, white or dark colors
  • can occur: upper back, lower legs, soles of feet, palms
  • almost always present as a change un a skin lesions that occur over a period of months
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6
Q

Skin Cancer Assessment

A
  • History of injury, sunburns/exposure, moles and other removal
  • Assess all areas of skin, including hair
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7
Q

ABCDE of skin assessment

A 
A: Asymmetry 
B: Borders
C: Color 
D: diameter
E: evolving
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8
Q

Labs and Diagnostics of Skin Cancer

A

No blood tests

  • Biopsy is the gold standard*
  • shave
  • punch
  • incinsional vs excisional
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9
Q

Skin cancer prevention

A

Primary: decreases sun exposure and tanning beds
Secondary: early detection, body spot map and frequent skin checks by self and PCP

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10
Q

Non surgical skin cancer treatment

A
  • Cryosurgery
  • Topical Chemotherapy
  • radiation therapy
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11
Q

Surgical Treatment for Skin cancer

A
  • curettage and electrodessication
  • ## excisions
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12
Q

Skin Cancer: Nursing Implications

A 
Implement interventions bases on adverse effects of treatments
-care for surgical sites 
-monitor for potential complications
Patient Education
- tests
- treatment and adverse effects
-medication adherence 
- ways to reduce UV light exposure
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13
Q

Lung Cancer

A
  • most common forms of cancer
  • Two types: non small cell; small cell (think smoking, always associated with smoking)
    -Five year survival at 16%
    early detection survival at 52%
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14
Q

pathophysiology of lung cancer

A
  • most are bronchogenic
  • can metastasize to surrounding tissue, blood, lymph
    Bronchial Tumor: obstruction of bronchus
    Tumor in lung: obstruction of the alveoli, nerves, blood vessels, lymph system
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15
Q

Risk factors for lung cancer

A
  • SMOKING duh!!
  • Second hand smoking
  • Radiation exposure
  • Environnemental exposure: pollutants, irritants
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16
Q

Prevention of lung cancer

A

Primary
- don’t smoke or quit smoking, vaping included
- use proper masks to prevent breathing environmental pollutants
Secondary
- high risk Patients: annuals CT’s

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17
Q

Lung Cancer Clinical Manifestations

A
  • chronic cough and dyspnea
  • fatigue
  • chest wall pain
  • Hoarseness
  • Chest wall Masses
  • clubbing of fingers
  • low pulse ox
  • visible masses
  • weight loss, anorexia, cachexia
  • hemoptysis
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18
Q

Lab and Diagnostics for lung cancer

A 
Chest X-ray
CT scan
PET scan
Pulmonary function test
sputum culture 
Thoracentesis 
ABG's 
Bronchoscopy
CT- guided biopsy
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19
Q

Nonsurgical treatment of lung caner

A

chemotherapy: used for Small cell
Radiation
Targeted therapy: targets cancers cells better than chemo
photodynamic therapy
radio frequency ablation: radiofrequenicies directly to tumor via needles

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20
Q

Surgical treatment for lung cancer

A

Wedge Resection: mall area of tumor near the surface of the lung is removed
Segmental Resection: removal of one or more lung segments
Lobectomy: removal of an entire lobe of the lungs
Pneumonectomy: removal of entire lung

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21
Q

Post Op Care for surgical interventions for lung cancer

A
  • monitor resp. status
  • monitor chest tube draining if applicable
  • incisional site care and dressing changes
  • drains/tube care
  • encourage ambulation
  • encourage incentive spirometry
  • Turn Cough and deep breath exercise with splinting
  • manage pain
  • monitor nutritional status
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22
Q

Lung cancer nursing implications

A 
care of side effects related to treatment 
maintain patent airway and suction PRN 
High Fowlers
oxygen therapy 
bronchodilators, and steroid (albuterol and montelukast)
Fluids
anxiety reduction
support and palliative care if needed
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23
Q

Leukemia

A

cancer of the bone marrow and common malignancy in children and young adults

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24
Q

pathophysiology of leukemia

A

uncontrolled proliferation of immature WBC’s

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25
Q

classifications of Leukemia

A
  • how fast the leukemia is progressing
  • types of blood cells affected
  • Acute VS Chronic
  • Lymphocyitc vs myelogenous
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26
Q

acute leukemia

A
  • immature blood cells
  • multiply rapid
  • requires aggressive, timely treatment
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27
Q

chronic leukemia

A

more mature cells
replicated more slowly
-no early symptoms and go unnoticed/undiagnosed for years

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28
Q

lymphocytic leukemia

A
  • affects lymphoid cells
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29
Q

myleogenous leukemia

A

affects myeloid cells

- Give rise to RBC’s, WBC’c and platelet producing cells

30
Q

major types of leukemia

A
  • Acute lymphocytic leukemia
    most common in children and 50% survival rate in adults
  • Acute myleogenous leukemia
    most common in adults, progonisis is poor
    -Chronic Lymphocytic leukemia
    most common, slowly progressing, occurs in adults in patient over 50
  • Chronic myleogenous leukemia
    affects adults
31
Q

Risk factors for leukemia

A
  • genetics
  • previous chemotherapy
  • ionizing radiation
  • certain chemicals
  • immunodeficiency
  • smoking
32
Q

clinical manifestations for leukemia

A
  • fever or chills
  • persistent fatigue or weakness
  • frequent or severe infections
  • losing weight without trying
  • swollen lymph nodes, enlarged liver or spleen
  • easy bleeding
  • recurrent nose bleeding
  • petechiae
  • excessive sweating, night
  • bone pain and tenderness
33
Q

labs and diagnostics for leukemia

A

Bone marrow aspiration and biopsy
CBC- low H/H, and platelets
INR, aPTT
CXR, CT,PET, bone scan- to check for mets

34
Q

Treatment for Leukemia

A

Chemotherapy in 3 phases

  • Induction: aggressive, 4-6 weeks
  • Consolidation: lower dosage, about 6 months
  • Maintenance: even lower doses, months to years to prevent relapse
35
Q

Treatment for leukemia

A

Biological Response Modifier
-Example: Filgrastim
Stimulated production of leukocytes: reduces time for neutrophil recovery following the induction or cosolidation

36
Q

Treatment for leukemia pt 3

A

Bone marrow/stem cell transplant

- bone marrow is destroyed using full body radiation or chemotherapy; replaced with healthy stem cells

37
Q

nursing implications for leukemia

A
  • patient is at risk for pancytopenia
  • implement interventions based on adverse effects of treatment
  • monitor for potential transplant complication (GVHD)
  • client education
38
Q

Lymphoma

A

Two types:

  • Hodgkins Lymphoma
  • Non-Hodgkins lymphoma
39
Q

Hodgkin’s lymphoma

A
  • contain Reed-Sternberg cells
  • usually in teens and young adults
  • starts in a single lymph node or chain of lymph nodes
  • predictable metastasis, starting with closest lymph nodes
40
Q

Non-Hodgkin’s Lymphoma

A
  • does not have Reed-Sternberg cells
  • most common with men and older adults
  • more than 65 subtypes
  • metastasis is unpredictable
41
Q

risks factors for Hodgkins lymphoma

A

unknown

-maybe with viral infections and exposure to certain chemicals

42
Q

risk factors for non-hodgkins lymphoma

A
  • gene damage
  • viral infections
  • radiation
  • autoimmune disease
  • chemicals
43
Q

clinical manifestations of lymphoma

A
  • often asymptomatic
  • large PAINLESS swelling of the lymph nodes
  • complaints of: fever, night sweats, weight loss, infection, general malaise
44
Q

labs and diagnostics for lymphoma

A
  • lymph node biopsy*
  • CBC
  • bone marrow biopsy
  • CT scan, CXR, PET, Bone scan
45
Q

Treatment for hodgkins lymphoma

A
  • chemo
  • radiation
  • immunotherapy
46
Q

treatment for non-hodgkins lymphoma

A
  • chemotherapy
  • radiation
  • immunotherapy
  • targeted therapy
47
Q

Nursing implications for lymphoma

A
  • implement interventions based on adverse effects of treatment
  • monitor for potential complications
  • client education on tests, treatment, adverse effects, and medications
48
Q

multiple myeloma

A

cancer of the plasma cells

Pathophysiology: cancerous plasma cells are known as MM cells, create abnormal antibodies M proteins

49
Q

risk factors for Multiple myeloma

A
  • older age (65 and older)
  • male
  • AA race
  • family history
  • obesity
  • personal history of other plasma cell disease
50
Q

clinical manifestations of multiple myeloma

A
  • bone pain in spine or chest
  • nausea, constipation
  • weight loss and loss of appetite
  • mental fog, confused, weakness
  • excessive thirst and urination
  • infection
  • kidney problems or failure
  • abdomen pain
51
Q

labs and diagnostics for multiple myeloma

A
  • CBC
  • CT, PET, Bone Scans, MRI
  • Creatinine
  • Albumin: typically low
  • Calcium: typically high
  • Lactic dehydrogenase: high, more advanced
  • urine
  • bone marrow biopsy
52
Q

treatment for multiple myeloma

A
  • chemotherapy
  • bone strengthening medications
  • immunotherapy
  • stem cell transplant
  • management of bone damage
53
Q

nursing interventions for multiple myeloma

A

-implement intervention based on adverse effects of treatment
- monitor for potential complicit
client education

54
Q

bone cancer pathophysiology

A

bone contain two types of cells

  • osteoblasts
  • osteoclast
  • not blood caner that starts in bone marrow*
55
Q

bone marrow types

A
  • osteosarcoma
  • chondrosarcoma
  • Ewing’s sarcoma
56
Q

osteosarcoma

A

most common bone caner

  • ages 10-30, or 60-40
  • often in arms, legs, pelvis
57
Q

chondrosarcoma

A

starts in any cartilage cells, including trachea, larynx, and chest wall

  • can be seen on scapula, ribs, and skull
  • most common in 20-75 years of age
  • equally in men and women
58
Q

Ewing’s sarcoma

A

most common sites are pelvis, chest wall, long bones of arms and legs
-most common in whites

59
Q

risk factors for bone caner

A
  • retinoblastoma increase risk of osteosarcoma
  • genetics
  • pagets disease
  • radiation
  • multipl enchodromtosis
60
Q

clinical manifestations for bone cancer

A
  • pain in affected bone
  • swelling of area
  • fractures
  • can press on nerves, causing numbness and tingling
  • weight loss
  • fatigue
61
Q

labs and diagnostics for bone cancer

A

-CBC, blood, urine and calcium levels are HIGH
- Alkaline phosphate, lactate dehydrogenase is also HIGH
-X-ray
Bone scan
CT
MRI
PET
Biopsy provides definite diagnosis

62
Q

Treatment of bone cancers

A
  • Surgery
  • radiation
  • chemotherapy
63
Q

colon (colorectal) cancer

A
  • starts off as polyps
    -Adenomatous polyps can become cancerous
    -hyper-plastic polys: common and are not cancerous
    most common location is in the rectosigmoid colon
64
Q

risk factors for colon cancer

A
  • women over men
  • age over 50
  • AA descent
  • UC or Chrons disease
  • Diet high in fat, red meat, low in fiber
  • smoking and alcohol consumption
  • inactivity
  • HPV
  • family Hx
65
Q

clinical manifestations for colon cancer

A
  • change in stool consistency
  • pencil thin stools
  • blood in stools
  • cramps
  • weight loss, vomiting
  • fatigue
  • abd fullness and distention and pain
66
Q

labs and diagnostics for Colon cancer

A
  • CBC, decreased H/H
  • Carcinoembryonic antigen (CEA): postive indicates malignancy
  • fecal occult blood test
  • colonscopy, sigmoidscopy
  • CT, MRI
  • barium enema
67
Q

surgical treatment of colon cancer

A
  • poypectomy
  • abdominal perineal resection: anus, rectum, and sigmoid colon is removed
  • colectomy: all or part of colon is removed, along with nearby lymph nodes
  • protococolectomy : colon and rectum removed
68
Q

Treatment of colon cancer

A
  • reanastomosis: reconnection of two ends of colon remaining
  • if unable to connect the two ends, ostomys are needed (colostomy and ileostomy)
  • stoma should be pink or red and moist
69
Q

non surgical treatment for colon cancer

A
  • chemotherapy
  • adjuvant therapy
  • radiation therapy
  • targeted medication therapy (monoclonal antibodies)
70
Q

what are some impacts of cancer

A
  • physical and psychological health
  • quality of life
  • financials
  • family dynamics

Care and Management (1 decks)

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