Exam 3 Other topic Questions Flashcards
(32 cards)
What is Graft vs, Host Disease?
Graft vs. Host disease is a complication usually regarding a stem cell transplantation. The donated stem cells the patients receives during the transplant view the hosts cells as foreign and the graft cells attack the host cells.
What are some risk factors for leukemia?
- Ionizing radiation
- Viral infection
- Exposure to chemicals and drugs.
What are risk factors for multiple myeloma?
- Radiation exposure
- Chemical exposure
- Infection with human herpesvirus
- Older age
- Common in males
- African American
- Obesity
- Family history
What is the pathophysiology of Leukemia?
Leukemia includes a group of malignant disorders that affect the blood and blood-forming tissues of the bone marrow, lymph system, and spleen. The loss of cell division regulation leads to the accumulation of dysfunctional immature white blood cells that, is left untreated, causes fatalities. The four types of leukemia are acute lymphocytic leukemia (ALL), acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), and chronic lymphocytic leukemia (CLL). Although patients diagnosed with leukemia may have a normal or high white blood cell count, they are at increased risk of infection. Bone marrow is responsible for making blood cells: WBCs. RBCs, and platelets. In leukemia there is an overproduction of white bloods cells that crowd out the production of normal cells, leading to low RBCs and low platelets.
What labs are associated with Chronic Myelogenous Leukemia (CML)?
- Increased WBCs (Norm: 4,500-11,000)
- Philadelphia chromosome
- Low hemoglobin (Norm: 12-18)
- Low hematocrit (Norm: 36-54)
- Low platelet (Norm: 150,000-450,000)
What is Hodgkin’s Lymphoma?
Lymphoma refers to cancer of the lymphatic system. A genetic mutation causes cells to rapidly multiply. The accumulation of these diseased lymphocytes causes swelling of the lymph nodes.
What would be some assessment findings in a patient with Hodgkin’s lymphoma?
- Fatigue
- Shortness of breath
- Cough
- Itching
- Night sweats
- Lack of appetite
- Swollen, painless lymph nodes
- Fever without infection
- Weight loss
What diagnostics would be done on a patient with Hodgkin’s lymphoma?
- Lymph node biopsy
- Blood test: Reed-Sternberg cells
What interventions would be done for a patient with Hodgkin’s lymphoma?
- Chemotherapy
- Radiation
- Lymph node removal
- Monitor for signs and symptoms of metastasis (high risk)
What medication therapy would a patient with Hodgkin’s lymphoma be on?
- Chemotherapy drugs
- Antiemetics for chemo side effects such as nausea
- Antihistamines for chemo side effects
- Analgesics for pain
What would be some assessment findings be in a patient with esophageal cancer?
- Weight loss
- Progressive dysphagia
- Anemia
- Abdominal pain
- Burning in chest
- Dark stool from digested blood
- Indigestion
- Nausea
- Vomiting blood
- Loss of appetite
What are some post surgical care things for a patient with esophageal cancer should be done?
- NG tube: Do not manipulate
- Assess respiratory status
- Semi-fowlers position
- IV fluids
- Pain management
- Nutritional support
When explaining what dumping syndrome is to a patient with stomach cancer, what should the nurse explain?
Dumping syndrome occurs when the stomach empties its contents rapidly into the small intestine. Partially digested food causes excess fluid to build up in the small intestine.
What are some side effects of dumping syndrome?
- Diarrhea
- Nausea
- Vomiting
- Dizziness
- Stomach cramping
- Heart palpitations
What are some risk factors for stomach cancer?
Environmental/ lifestyle
Diet
- Smoked foods
- Nitrates
- High sodium intake
- Tobacco
- Alcohol
Infection/ Disease
- H. Pylori infections
- Epstein Barr Virus
- Chronic gastric atrophy
- Pernicious anemia (Low B12)
Familial
- FAP: Familial Adenomatous polypsis
- HNPCC: Hereditary nonpolyposis colon cancer
What are some risk factors for colorectal cancer?
Non-modifiable
- Over the age of 50
- Genetic predisposition
- Personal/ family history
- Diseases that predispose the patient to cancer.
Modifiable
- Smoking
- Obesity
- Physical inactivity
- Heavy alcohol consumption
- High fat diet
What are some diagnostics that are done to help confirm colorectal cancer?
- Colonoscopy: To be able to visualize the colon
- Fecal Occult Blood Test (FOBT): Used to detect blood in the stool, which could indicate the presence of cancer.
What are some discharge teaching points that the nurse should educate a patient with laryngeal cancer on?
- Avoid swimming and use care when showering and shaving.
- Lean slightly forward and cover the stoma when coughing or sneezing.
- Wear a stoma guard or loose fitting clothing to cover the stoma.
- Clean the stoma with mild soap and water. Lubricate the stoma with a non-oil based ointment as needed.
- Increase humidity by using saline in the stoma as instructed, a bedside humidifier, pans of water, and house plants.
- Obtain and wear a MedicAlert bracelet and an emergency care card for life-threatening situations.
What are some immediate post op care things that the nurse should do/monitor for in a patient with laryngeal cancer?
- Airway maintenance
- Ensure gas exchange
- Managing wound and wound breakdown
- Managing pain
- Maintaining nutrition (via NG tube, gastrostomy, or jejunostomy tube)
- Promoting communication ( via esophageal speech, mechanical devices, or tracheoesophageal puncture)
- Preventing aspiration
- Supporting self-esteem
What are treatment options for Small Cell Lung Cancer?
- Chemotherapy
- Targeted therapy
- Immunotherapy
- Radiation therapy
- Photodynamic therapy: may be used to remove small bronchial tumors when they are accessible by bronchoscopy.
- Palliative care
What are treatment options for non-small cell lung cancer?
Stages 1&2
- Surgery (pneumonectomy, lobectomy, segmental or wedge restriction)
- Medical (chemotherapy, targeted therapy, immunotherapy, radiation therapy, photodynamic therapy)
Stages 3&4
- Medical (chemotherapy, targeted therapy, immunotherapy, radiation therapy, photodynamic therapy)
- Palliative (palliative care/ palliation; which may include palliative surgery.)
In what ways does cancer metastasize?
Direct extension: The primary tumor grows into tissue or structures around it.
Blood circulation: Cancer cells break away from the original (primary) tumor, travel through the blood and form a new tumor in other organs or tissues of the body.
Lymph system: The spread of cancer cells into a lymph node.
For cancer in general; what is tumor lysis?
Tumor lysis syndrome is when large numbers of tumor cells are destroyed rapidly. The intracellular contents and subsequent by products of damaged cancer cells are released into the bloodstream faster than the body can eliminate them. Severe or untreated tumor lysis syndrome can cause acute kidney injury and death.
For can in general; what is superior vena cava syndrome?
The superior vena cava returns all the blood from the head, neck, and upper extremities to the heart. Compression or obstruction by tumor growth or by clots in this vessel leads to congestion of blood returning to the body. This is known as superior vena cava syndrome and can develop quickly or gradually over time. Superior vena cava syndrome occurs most often in patients with mediastinal tumors, or tumors near the chest wall or indwelling catheters.
