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Med Surg 3 Exam 2 > Caring for Patients with Cancer > Flashcards

Caring for Patients with Cancer Flashcards

1
Q

what is cancer

A

group of diseases characterized by uncontrolled and unregulated growth and spread of abnormal cells

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2
Q

what is the pathophysiology of cancer

A
  1. carcinogens- chemical, physical or viral
  2. promotion - enhanced growth
  3. progression
  4. primary and secondary tumor
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3
Q

what is a benign tumor

A

normal cells growing in the wrong place or at the wrong time - look and act like parent cell

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4
Q

what is malignant cancer

A

abnormal cells that are harmful to body tissue, rapidly divide serve no function and invade other tissues

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5
Q

what is grade 1-4 of cancer

A

1 cells differ slightly from normal cells - are well differentiated
2 cells are more abnormal - are moderately differentiated
3 cells are very abnormal - poorly differentiated
4 cells are poorly differentiated and retain no normal cell characteristics - cannot determine tissue of origin

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6
Q

what is staging 0-4 of cancer

A

Stage 0: cancer in situ
Stage 1: tumor limited to tissue of origin; localized growth
Stage 2: limited local spread
Stage 3: extensive local and regional spread
Stage 4: metastasis

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7
Q

what does the T stand for in TNM staging

A

primary Tumor 0-4 - aka the sike or local extend of primary tumor

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8
Q

what does N stand for in TNM staging

A

Lymph Nodes - 0-3 - involvement of lymph nodes

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9
Q

what does M stand for in TNM staging

A

Metastasis 0-1

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10
Q

what kind of diagnostics test could be used to ID cancer

A

CT scan, MRI, PET, Cytology studies, Biopsy (shave, needle, incisional/excisional, sentinel lymph node), Endoscopy, Blood tests – liver function tests, tumor marker assays (PSA)

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11
Q

what are some risk factors for cancer

A

age, immune function, chronic irritation, tissue trauma, race, genetics, exposure to chemicals/tobacco/alcohol/viruses, diet, sun, UV exposure, sexual lifestyle, obesity, chronic disease, air pollution

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12
Q

when should someone get a mammogram

A

annually for women > 40

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13
Q

when should someone get clinical breast exams

A

annually for women > 40 (every 3 years for women 20-39)

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14
Q

when should someone get a colonoscopy

A

at age 50 then every 10 years

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15
Q

when should someone get a fecal occult blood test

A

annually for adults of all ages

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16
Q

when should someone get a digital rectal exam

A

men > 50

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17
Q

what does CAUTION stand for 7 warning signs of cancer

A

changes in bowel or bladder, A sore throat that doesnt heal, unusual bleeding or discharge, thickening or lump, Indigestion or difficulty swallowing, Obvious change in wart or mole, Nagging cough or hoarseness

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18
Q

what could be some causes of pain in cancer

A

Bone destruction (pathologic fx or lytic lesions), Organ obstruction, Nerve compression, Distention of tissue, Inflammation,necrosis,tumor lysis, Psychologic factors (fear, anxiety), Treatment associated (surgical paint, neuropathic pain)

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19
Q

what should you do if pain relief doesnt last long enough

A

extended release meds

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20
Q

what should you do if pain controlled most of the time but some break through pain

A

fast acting or immediate release opiod

21
Q

what should you do if current pain regimen is not working as well as it did

A

consider opioid tolerance and change or type of medication

22
Q

what are some routes of chemotherapy

A

topical, oral, parenteral, IV (also – intra-arterial, intraventricular, intracavitary, intrathecal)

23
Q

what is chemo therapy

A

Chemical agents that damage the cancer cells’ DNA (interfering with cell division and cellular regulation) or destroy rapidly dividing cells - Chemotherapy is cytotoxic

24
Q

what should be considered before giving chemotherapy

A

Giving chemotherapy requires special education and training, Appropriate PPE, Assessment, Pre-meds or cytoprotectants, Irritant or vesicant, Administer on time, Allergies, labs,

25
Q

what should you do for extravasation during chemo

A

stop chemo, put on chemo ppe, leave IV in place, disconnect the tubing and replace with disposable syringe without placing any pressure on site, aspirate as much of the drug as possible, give antidote, call doc, remove IV while aspirating, elevate for 48hrs, reestablish IV access, complete incident report

26
Q

what are some chemo side effects and what should you do

A

immunosuppression/neutropenia ( risk for infection, absolute neutrophil count), N/V anorexia (antiemetics, non pharm management), alopecia (body image concerns), mucositis stomatitis (NS rinses, acylovir, nystatin, lidocaine), anemia, SOB, thrombocytopenia, peripheral neuropathy, infertility, pain, organ damage

27
Q

what do antimetabolites do

A

Act as “counterfeit” metabolites that fool cancer cells into using the antimetabolites in cellular reactions

28
Q

what are antitumor antibotics

A

Damage the cell’s DNA and interrupt DNA or RNA synthesis
Doxorubicin

29
Q

what is radiation in cancer tx

A

Ionizing radiation to target tissues and destroy cells
Radiation dose (Gy)
External (teletherapy) and Internal (brachytherapy)

30
Q

what are adverse effects of radiation

A

skin changes (erythema, desquamation, sloughing), hair loss, debilitating fatigue, bone marrow suppression

31
Q

what are some acute side effects of radiation

A

Brain: alopecia, dermatitis of scalp, N/V, blurry vision
Head/neck: oral mucositis, dysphagia
Chest/lung: pneumonia, cough, esophagitis, dyspnea
Abdomen/pelvis: anorexia, N/V/D, sexual or fertility problems

32
Q

what are some late side effects of radiaiton

A

CNS: brain necrosis, cognitive and emotional dysfunction
Head/neck: hypothyroidism
Lung: pulmonary fibrosis
Heart: pericarditis, CAD
Abdomen/pelvis: bowel injury, diarrhea

33
Q

what is included in brachytherapy safety

A

Private room, door closed
All nurses/assistants will wear film badge and lead apron
Visitors: 30 min, 6 ft from source
No visitors under 18 or pregnant
Cluster Care
No full baths should be given by staff
If radioactive source falls out – call radiation oncologist immediately

34
Q

what is immunotherapy

A

the use of the body’s own defense system to attack the foreign cells

35
Q

what is targeted therapy

A

target cell receptors and pathways used in tumor growth aka. cytostatic

36
Q

what is monoclonal antibodies

A

bind to target antigens to change cellular regulation and prevent cancer cell division

37
Q

what is endocrine therapy

A

: Effective against tumors that are supported or suppressed by hormones

38
Q

what is the nursing care for surgrey for cancer

A

Prevent postop complications – infection, fluid/electrolyte imbalance, hemorrhage, thromboembolism, inadequate oxygen, shock

39
Q

what is stem cell transplants

A

Procedure that infuses healthy blood-forming stem cells into your body to replace your damaged or diseased bone marrow
Autologous (self cells) vs. Allogeneic (donor cells)

40
Q

what are the phases of stem cell transplants

A

Stem cell harvest, Conditioning regimen, Transplantation, Engraftment, Post transplantation recovery

41
Q

what is a tumor lysis syndrome and what labs does in normally affect

A

Large numbers of tumor cells destroyed rapidly
Hyperuricemia (AKI), hyperkalemia (cardiac dysfunction), hyperphosphatemia (hypocalcemia)

42
Q

what are the early signs of tumor lysis syndrome

A

lethargy, N/V, flank pain, muscle weakness, cramps, seizures, AMS

43
Q

what is the treatment of tumor lysis syndrome

A

IV fluids, allopurinol, diuretics, glucose/insulin, call oncologist first to diagnose

44
Q

what is the patient education for tumor lysis syndrome

A

drink 3L of fluid, follow antiemetic regimen

45
Q

what is specific to palliative services

A

paid by insurance or self, any stage of disease, same time as curative treatments, typically in a hospital

46
Q

what is specific to hospice services

A

paid by medicare, medicaid insurance, prognosis 6 months or less, excludes curative tx, wherever patient calls home

47
Q

what do palliative and hospice services have in common

A

comfort care, reduce stress, offer complex symptom relief related to serious illness, physical and psychosocial relief

48
Q

what are the physical ss of approaching death

A

Coolness of extremities, Increased sleep, Fluid and food decrease, Incontinence, Congestion/gurling, Breathing pattern change, Disorientation, Restlessness

Med Surg 3 Exam 2 (3 decks)

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