Health promotion and Scientific Basis Flashcards
(33 cards)
Test Strategies
- “guarantee/always” is not the answer
- take out the ones absolutely wrong
- Debate over 2 correct answers, re-read and choose correct one
- do T/F w/each question
- If things look the same put your fingers on the words
- Go with the answer you think is right
- General concepts about all instead of all details about everything
Cancer incidence
- rates continue to rise
- gap btwn incidence/death is widening (more cured than dying)
- Male more than female
- Top: Lung, prostate, breast
- Male: H/N
- Female: Thyroid
- Hereditary disposition: 5-10%
Carcinogenesis
- Oncogenes: gene w/potential to cause cancer
- protooncogenes: “GAS PEDAL”
- Exposure to factor will cause activation of protoncogenes and inactivation of tumor suppressor genes (P53=brake)
- Plasia
- Anaplasia
- Dysplasia
- Hyperplasia
- Plasia: “formation”
- Anaplasia: loss of
- Dysplasia: abnormal
- Hyperplasia: excessive
- Carcinoma
- Sarcoma
- Germ cell
- Carcinoma in situ
- Carcinoma: Arising from epithelial cells
- Sarcoma : Arising from muscle/bone/connective tissue
- Germ cell: Arising from embryonic cells
- Carcinoma in-situ: non-invasive, not crossed basement membrane
Malignant vs Benign
Malignant: can invade/metastasize
Benign: cannot invade
Adenocarcinoma Squamous cells Differentiation Metastasis Angiogenesis Apoptosis
- Adeno: GLANDULAR epithelial cells
- Squamous: pancake cells that line the canals and cavities of the body
- Differentiation: cell maturation
- Metastasis: move to other places
- Angiogenesis: leaching to existing blood supply
- Apoptosis: programmed cell death
Incidence
Prevalence
Mortality
- Incidence: # of CANCERS that develop in a population during a DEFINED period
- Prevalence: Actual # of cancers that exist at a given time #/100k people
- Mortality: # of people die of a particular cancer during a defined period
Ethical Theory: Utilitarianism
overall balance of positive and negative effects of your actions; all actions are considered on the basis of consequences
Primary Prevention
Secondary Prevention
Tertiary Prevention
- Primary: This could PREVENT the cancer, Ex: Vaccines, exercise, smoking cessation
- Secondary: This could CATCH IT EARLY, ex: mammogram, colonoscopy
- Tertiary: LTFU, SURVIVORSHIP, for people who already had cancer, Ex: maintenance, scans, hormone blocking agent
Relative risk
Absolute risk
Attributable risk
Cumulative risk
- Relative risk: probability of getting cancer based on the risks
- Absolute risk: Cancer incidence or mortality
- Attributable risk: amount of disease in a population that could be avoided by reducing or eliminating risk
- Cumulative risk: the total amount of risk of developing a disease over time ex: 1in4 men develop prostate their whole life
Types of risk factors: Lifestyle Occupational Environmental Viral Iatrogenic
- Lifestyle: smoking, alcohol, diet
- Occupational: chemicals
- Environmental: Sun tanning beds, radiation
- Viral: HBV/HCV, HPV, EBV, HIV
- Iatrogenic: Immunosuppression, Hormone replacement, Radiation/Chemo
Hereditary cancers: BRCA1&2 HER2 HNPCC FAP (APC gene) Dysplastic Devi Von hippel landau
- BRCA1&2: breast ovarian
- HER2: breast, ovarian, GI
- HNPCC: GI, liver, upper urinary, brain, skin, ovary, endometrial
- FAP (APC gene): colon
- Dysplastic Devi: melanoma
- Von hippel landau: cancer in fluid filled sacs
Secondary Screening:
Pap smear start
Screening year
Familial history
- Pap smear start - sexually active
- Screening year=50yo
- Familial history start screening 10yrs prior
Cancer stages: Stage 1 Stage 2 Stage 3 Stage 4
- Stage 1: Tumor only, surgery/radiation main tx
- Stage2: Tumor+lymph node, local+systemic therapy “adjuvant: surgery then systemic”
- Stage 3: Tumor+many lymph nodes that drain that organ, reduce tumor first before surgery “neoadjuvant”
- Stage 4: Tumor in other areas, shrink tumor before surgery/Radiation
Metastatic sites:
Above diaphragm
Abdominal cancers
- Above diaphragm cancers are metastatic ALL OVER
- Abdominal cancers are metastatic to mostly abdominal area
Lab tests:
- LDH
- Alk phos
- Lab tests monitor the disease, they are mostly prognostic
- LDH: increased is a marker for proliferation
- Alk phos: increased is a marker for bone metastasis
Tumor markers: Liquid biopsies CEA HCG AFP CA-125 CA27-29; 15-3 CA9-19 B2M PSA
Liquid biopsies: circulating tumor cells CEA: GI HCG: Reproductive AFP: testicular, liver CA-125: Ovarian CA27-29; 15-3: Breast CA9-19: Pancreatic B2M: Lymphocytic PSA: Prostate
Diagnostic Imaging: CT MRI PET Bone scan
- CT: visualize mass, solid tumors, PE, infection, bleed
- MRI: More dense organs, bone, brain/CNS, abdominal tumors, dense breast
- PET: shows activity, faster growing cancers, lymphoma, esophageal, cancer cells take up contrast and light up scan
- Bone scan: shows bone mets
Pain
Somatic
Neuropathic
Visceral
Somatic pain
- well localized: aching, throbbing or gnawing
Neuropathic pain
- pain cause by damaged or alteration of
Nervous system
Visceral pain
- not localized
- vague -pain receptors in pelvic, chest, abd or intestine
- feel as deep squeeze pressure or aching
TNM staging
T=Tumor X:No info 0:No primary tumor is:Pre-cancer 1-4:staging
N=Lymph nodes X:Not assessed 0:None 1-3:staging
M=Mets 0:No 1:Yes
Nursing Role in Accreditation Process
- Participate in QI at micro, meso, and macrosystem level
- Vigilant focus on patient SAFETY and creating a HEALTHY work environment
- Participation in ongoing surveillance programs thr data collection, management, and analysis
- Preparatory activities
Sheridan-Leos
5 qualities of high reliability teams and organisation
to maintaining quality and accreditation to promote safety across all care
- Preoccupation with failure
- Reluctance to simplify
- sensitivity to operations
- Resilience
- Deference to expertise
what the hell is this!
Benefits of Magnet Recognition for institution
defined by ANCC
- Attract and retain top talent
- Improve pt care, safety and satisfaction
- Foster a collaborative culture
- Adv nursing standards and practice
-Grow the business, resulting in FINANCIAL success