cell reg pp 2

Question 1

What is the second most common malignancy among American women?

Answer 1

Breast cancer

Breast cancer is also the second most common cause of death among women.

Question 2

What are the primary risk factors for developing breast cancer?

Answer 2

• Family history
• Genetics
• Age 60 or older
• Early menarche, late menopause
• Hormone therapy (estrogen + progesterone)
• Environmental factors
• Most women have no identifiable risk factors

These factors contribute to the risk but not all women with breast cancer have identifiable risk factors.

Question 3

What percentage of breast cancers are hereditary?

Answer 3

5% to 10%

Most hereditary breast cancers are associated with mutations in BRCA1 and BRCA2 genes.

Question 4

What are the two main types of breast cancer?

Answer 4

• Noninvasive (in situ)
• Invasive (spreading to other locations)

Noninvasive includes Ductal carcinoma in situ (DCIS) while invasive includes Invasive ductal carcinoma (IDC) and Invasive lobular carcinoma.

Question 5

What is a common characteristic of inflammatory breast cancer?

Answer 5

Skin red, warm, with a thickened appearance resembling an orange peel (peau d’orange)

Inflammatory breast cancer is the most malignant form of breast cancer.

Question 6

What defines metastasis in breast cancer?

Answer 6

Malignant cells are spread by blood and lymph systems to distant organs

Common sites for metastasis include brain, lungs, liver, and bones.

Question 7

What is the purpose of mammography in breast cancer diagnosis?

Answer 7

Screening for breast cancer

Digital mammography is more accurate in younger women whose breasts are denser.

Question 8

What is the significance of axillary lymph node analysis in breast cancer?

Answer 8

One of the most important prognostic factors

The more lymph nodes involved, the greater the risk of recurrence.

Question 9

What is the treatment for triple-negative breast cancer?

Answer 9

Chemotherapy

Triple-negative breast cancer tests negative for estrogen, progesterone, and HER-2 receptors, making it more aggressive.

Question 10

What does neoadjuvant therapy refer to?

Answer 10

Therapy given before surgery to shrink the size of the tumor

The opposite of neoadjuvant: Adjuvant therapy is given after surgery to decrease the rate of recurrence.

Question 11

What is the role of hormone therapy in breast cancer treatment?

Answer 11

Blocks the effect and source of estrogen, promoting tumor regression

Estrogen can promote the growth of breast cancer cells if they are estrogen receptor positive.

Question 12

What are some common psychosocial considerations for patients with breast cancer?

Answer 12

• Sensitivity to the psychological impact of diagnosis/surgery
• Providing a safe environment for expression of feelings
• Helping identify sources of support

Communication with family and friends is also crucial.

Question 13

What is the most common surgical procedure for operable breast cancer?

Answer 13

Breast conservation surgery (lumpectomy)

Mastectomy is another common option, with variations including simple and modified radical mastectomy.

Question 14

What is lymphedema and how can it occur after breast cancer surgery?

Answer 14

Accumulation of lymph in soft tissues after lymph node sampling or radiation therapy

It occurs because lymph fluid cannot return to central circulation.

Question 15

What is the most common type of colorectal cancer?

Answer 15

Adenocarcinoma

It accounts for a large percentage of colorectal cancer cases.

Question 16

What are common risk factors for colorectal cancer?

Answer 16

• Age over 50
• Obesity
• Smoking
• Alcohol consumption
• Low-fiber diet
• Personal or family history of colorectal cancer

Genetic conditions like Familial Adenomatous Polyposis (FAP) also contribute.

Question 17

What is the purpose of regular screening for colorectal cancer?

Answer 17

To identify precancerous lesions

Colonoscopy is the typical method used for screening.

Question 18

What are colonic polyps and their significance?

Answer 18

Growths on the inner lining of the colon that may become cancerous

Adenomatous polyps are the most common type and a common cause of colorectal cancer.

Question 19

What is the most common type of colorectal cancer?

Answer 19

Adenocarcinoma

Adenocarcinoma accounts for the majority of colorectal cancer cases.

Question 20

How do tumors in colorectal cancer spread?

Answer 20

Through the walls of the colon into musculature and into the lymphatic and vascular systems

This allows for metastasis to lymph nodes, liver, lungs, bone, brain, and adjacent organs.

Question 21

What are colonic polyps?

Answer 21

Growths on the inner lining of the colon that protrude into the colon

More common with aging and may become cancerous.

Question 22

What is the most common type of polyp that leads to colorectal cancer?

Answer 22

Adenomatous polyp

It is the most common cause of colorectal cancer.

Question 23

What is a common symptom of advanced colorectal cancer?

Answer 23

Change in bowel habits

Other symptoms include unexplained weight loss and vague abdominal pain.

Question 24

What is the most common symptom associated with cancerous lesions in colorectal cancer?

Answer 24

Rectal bleeding

Other symptoms include weakness, iron-deficient anemia, and alternating constipation and diarrhea.

Question 25

What is the gold standard method for diagnosing colorectal cancer?

Answer 25

Colonoscopy ## Footnote It allows for examination of the entire colon and enables biopsies.

Question 26

What is the TNM system in colorectal cancer?

Answer 26

T= Tumor size, N= Nodal involvement, M= metastasis ## Footnote It is the preferred classification system to determine cancer stage.

Question 27

What surgical procedure is performed to resect colorectal cancer in situ?

Answer 27

Polypectomy ## Footnote It can be done during colonoscopy for stage 0 tumors.

Question 28

What is the purpose of chemotherapy in colorectal cancer treatment?

Answer 28

To shrink the tumor before surgery and as palliative treatment for Stage IV colorectal cancer ## Footnote It may also be used alongside colon resection.

Question 29

What type of therapy involves preventing the growth of new blood vessels at tumors?

Answer 29

Biologic & Targeted Therapy ## Footnote Angiogenesis inhibitors like Bevacizumab (Avastin) and ziv-aflibercept (Zaltrap) are examples.

Question 30

What are some complications of colorectal cancer?

Answer 30

Bowel obstruction, bleeding, perforation of bowel, peritonitis, fistula formation ## Footnote These complications can arise from the cancer itself.

Question 31

What is the primary focus of postoperative care in colorectal cancer?

Answer 31

Management depending on the type of wound ## Footnote This includes monitoring for infection and managing drainage.

Question 32

What is an ileostomy?

Answer 32

Surgery to create a stoma from the ileum, bypassing the colon, rectum, and anus ## Footnote It allows waste to leave the body.

Question 33

What is the difference between a temporary and permanent ostomy?

Answer 33

Temporary ostomy allows an organ to heal; permanent ostomy is for when an organ must be removed ## Footnote Permanent ostomy is necessary when anastomosis isn’t possible.

Question 34

What is acute myelogenous leukemia (AML)?

Answer 34

Uncontrolled proliferation of myeloblasts leading to hyperplasia of bone marrow and spleen ## Footnote Symptoms include serious infection or abnormal bleeding.

Question 35

What is the initial goal of leukemia treatment?

Answer 35

To attain remission ## Footnote This can be complete, partial, or molecular.

Question 36

What are some diagnostic studies used for leukemia?

Answer 36

CBC with differential, peripheral blood evaluation, bone marrow examination ## Footnote These help classify types of leukemia.

Question 37

What is the role of corticosteroids in leukemia treatment?

Answer 37

Used in combination with chemotherapy and radiation therapy ## Footnote They help to manage symptoms and improve outcomes.

Question 38

What is leukostasis?

Answer 38

Impaired perfusion due to accumulation of leukemic cells ## Footnote This can lead to organ dysfunction.

Question 39

What does the term 'double barrel stoma' refer to?

Answer 39

A temporary stoma created by dividing the bowel and bringing up both proximal and distal ends to the skin surface ## Footnote The distal stoma is non-functioning but secretes mucus.

Question 40

What are common treatments for leukemia?

Answer 40

Corticosteroids, Radiation therapy, Total body radiation, Immunotherapy, Targeted therapy, Colony stimulating factors ## Footnote Total body radiation is often used in preparation for bone marrow transplantation.

Question 41

What is the goal of Hematopoietic Stem Cell Transplant in leukemia treatment?

Answer 41

Totally eliminate leukemic cells using combinations of chemotherapy with or without total body irradiation ## Footnote This process eradicates the patient's hematopoietic stem cells, which are replaced with HLA-matched or the patient's own stem cells.

Question 42

What subjective data should be assessed in nursing management for leukemia patients?

Answer 42

Past health history, Exposure to toxins, Chromosome abnormalities, Frequent infections, Medications, Previous chemotherapy, Surgery or radiation treatments ## Footnote Subjective data provides insights into the patient's background and potential risk factors.

Question 43

List some objective data to assess in leukemia patients.

Answer 43

* Fever * Lymphadenopathy * Lethargy * Pallor * Jaundice * Petechiae * Ecchymoses * Cardiovascular signs like tachycardia * Gastrointestinal issues like oral lesions, bleeding, hepatomegaly, splenomegaly * Neurological symptoms like seizures, disorientation, confusion * Muscle wasting * Bone or joint pain ## Footnote Objective data includes observable symptoms and vital signs.

Question 44

What are common diagnostic findings in leukemia patients?

Answer 44

* Normal or abnormal WBC counts * Anemia * Decreased Hct and Hgb * Thrombocytopenia * Abnormal (hypercellular) bone marrow aspirate or biopsy ## Footnote These findings help in diagnosing and understanding the extent of leukemia.

Question 45

What are the overall goals in nursing management planning for leukemia?

Answer 45

* Understand and adhere to treatment plan * Experience minimal side effects and complications * Establish realistic hope and goals * Feel supported during treatment, relapse, and remission ## Footnote Goals focus on the patient's well-being and adherence to treatment.

Question 46

True or False: Acute care for leukemia patients involves addressing both physical and psychological needs.

Answer 46

True ## Footnote Leukemia evokes great fear and may be equated with death, necessitating supportive care.

Question 47

What special challenges do nurses face when caring for leukemia patients?

Answer 47

* Meeting intense psychosocial needs * Managing life-threatening side effects of treatment * Reviewing all drugs administered * Assessing lab data reflecting drug effects and disease sequelae ## Footnote Involving an interprofessional team can enhance patient care.

Question 48

What is essential for ongoing care in leukemia patients?

Answer 48

* Monitoring for signs of relapse * Meeting unique needs of cancer survivors * Teaching patient and caregiver about disease management ## Footnote Follow-up care is critical for long-term health.

Question 49

Fill in the blank: In the induction stage of chemotherapy for acute myelogenous leukemia, the drugs are started _______.

Answer 49

[slowly to minimize side effects] ## Footnote This is important to reduce the risk of complications.

Question 50

What is a common risk during the induction stage of chemotherapy for leukemia patients?

Answer 50

Increased risk for bleeding and infection ## Footnote Patients must be monitored closely during this phase.