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N443 > Lung Cancer > Flashcards

Lung Cancer Flashcards

1
Q

Cellular Reproduction & Growth

A

Proliferation: new cell formation; mitosis & meiosis

Differentiation: acquisition of a cell role

Normal Replication Rate: one cell dies, one is created

Cell Signaling: needs a precise & error-free process

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2
Q

Complications

Neoplasia

A

Abnormal and progressive multiplication of cells

Benign or malignant

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3
Q

Lung Cancer

A

– starts in the lungs ->lymph nodes & brain = common

Metastases: when cancer that forms in one organ -> moves to another/spreads

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4
Q

Two types of lung cancer

A

Small cell

Non Small cell

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5
Q

Smoking = 80-90% of all lung cancers

A

Tobacco smoke contains 60 + carcinogens that interfere with normal cell development
Risk decreases with cessation: 10-15 years to reach same risk level as non-smokers

Risk depends on: pack years, depth of inhale, tar or nicotine content, filter use.

Pollution
Radiation (especially radon exposure)
Asbestos
Industrial Agents: coal dust, nickel, uranium, chromium, formaldehyde, arsenic
Leading cause of cancer related deaths in US; >breast, prostate & colon combined

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6
Q

Who’s at Risk?

A

Smoking
Secondhand Smoke
Radiation Exposure
Occupational Exposure
Air Pollution
Family History (behavior or genetic predisposition = uncertain)
*Smoking potentiates effects of all other risk factors

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7
Q

Non-Small Cell Lung Cancer

3 Main Types: each type has different cells, grouped together because treatment and prognosis is similar

A

Adenocarcinoma: begins in alveoli cells that make mucus; current or former smokers & non-smokers; women > men, younger patients; found in outer areas of lung; usually caught before it has spread

Squamous Cell Carcinoma: thin, flat cells; found in central lungs near bronchus; smokers

Large Cell Carcinoma: begins in several types of large cells – any area of lungs; spreads quickly = hard to treat

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8
Q

Small Cell Lung Cancer

2 Main Types:

A

Small Cell Carcinoma or “Oat Cell Cancer”:
Combined Small Cell Carcinoma:
Staging: Limited or Extensive
Treatment: tends to respond well to chemotherapy and radiation
Prognosis: likelihood that it will return is high

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9
Q

Metastisis

A 
Tests to determine “stage” of the cancer 
NSCLC
Occult (hidden) stage
Stage I, II, III, IV
Small Cell
Limited or Extensive
Cancer and How it Spreads  *VIDEO *
Tissue, Lymph System or Blood
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10
Q

Paraneoplastic Syndrome

A

Caused by hormones, cytokines, enzymes or antibodies
Autoimmune response to presence of tumors
Symptoms
Examples: hypercalcemia, SIADH, adrenal hypersecretion, polycythemia, Cushing Syndrome
*may manifest even before malignancy is diagnosed
*most often seen with SCLC
*Conditions may stabilize with treatment of the underlying neoplasm

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11
Q

Clinical Manifestations

A 
*repeated episodes of lobar pneumonia
Cough that doesn’t go away
Chest Pain
Shortness of Breath
Wheezing
Coughing up blood
Later manifestations: 
Fatigue
Weight Loss w/no known cause
Nausea and Vomiting
Hoarseness
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12
Q

Screening

A 
Who should be screened?
Hx of Heavy Smoking, and
Smoke now or quit within 15yrs, and
Between 55-80 yrs old
Heavy Smoking = 30 pack years or more
A “pack year” = 1 pack of cigarettes per day for one year
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13
Q

Treatments

A

Surgical Therapy
One lung and nearby lymph nodes only
May remove lung tissue, lymph node or biopsy
May be followed by chemotherapy or radiation to kill left over cancer cells
Radiation Therapy
External (used for Small cell); typically for palliative therapy (relieve symptoms)
Internal (seeds, wires, catheters w/ radioactive substances)
Chemotherapy
Mouth, IV in vein, or placed directly into the cerebrospinal fluid, an organ or body cavity
Immunotherapy

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14
Q

The Nursing Process

A
  • Assessment
    Subjective and Objective
  • Diagnosis
    Understanding of : tests, diagnosis, treatment options and prognosis
    Be sure to assess anxiety and support system on a regular basis
  • Planning
    Priorities : (1) effective breathing patterns, (2) adequate airway clearance, (3) adequate oxygenation of tissues, (4) minimal to no discomfort, and (5) a realistic attitude about treatment and prognosis.
  • Interventions
    Smoking cessation, healthy lifestyles, avoid environmental hazards (radon)
  • Evaluation
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15
Q
  1. True/False: The more cigarettes you smoke per day and the earlier you started smoking, the greater your risk of lung cancer.
A

True
*risk is directly related to “total exposure” to tobacco smoke (# of cigarettes, age, depth of inhale, tar & nicotine content, filter/no filter)

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16
Q
  1. Symptoms depend on the specific type of cancer you have, but may include all except:
    a. Cough that doesn’t go away
    b. Coughing up blood
    c. Loss of appetite
    d. gaining weight without trying
A

D

* most patients lose weight; other common symptoms: Shortness of breath, Wheezing, Chest pain

17
Q
  1. In some cases, the health care provider may need to remove a piece of tissue from the patient’s lungs for examination under a microscope. This is called a :
    a. Positron emission tomography (PET) scan
    b. sputum cytology test
    c. biopsy
    d. CT scan
A

C
* This is called a biopsy. There are several ways to do this: Bronchoscopy combined with biopsy, Pleural biopsy, CT scan directed needle biopsy, Mediastinoscopy with biopsy, Open lung biopsy.

18
Q
  1. Outlook (Prognosis) or how well a patient does depends on the all of following except:
    a. Type of lung cancer
    b. Whether or not the cancer has spread
    c. the patient’s age
    d. the patient’s blood type
A

D
*blood type is not considered a factor in the prognosis; other factors may be the overall health status of the patient and how well they respond to treatments

19
Q
  1. True/False: The earlier the cancer is found, the better the chances of survival. Lung cancer is a deadly disease. Nearly 60% of people with lung cancer die within a year.
A

True

20
Q
  1. True/False: Small cell lung cancer is the most common type of lung cancer. It usually grows and spreads more slowly than non- small cell lung cancer (NSCLC).
A

False
*non-small cell is most common & grows slow. Small cell lung cancer accounts for about 20% of lung cancer cases, grows very rapidly, spreads via the lymphatic system & bloodstream, patients will often have mets to brain

21
Q
  1. Which of these is not one of the three types of NSCLC?
    a. adenocarcinomas ~moderate growth rate
    b. squamous cell carcinomas ~slow growth rate
    c. large cell carcinomas ~rapid growth rate
    d. basal cell carcinomas
A

D

Basal cell carcinoma is a type of skin cancer

22
Q

8.True/False: Adenocarcinomas are often found in an outer area of the lung.

A

True

23
Q
  1. True/False: Large cell carcinomas are usually found in the center of the lung, in bronchi.
A

True

* Large cell carcinomas tend to grow and spread faster than the other two types.

24
Q
  1. After quitting, it takes tobacco smokers ______ years to reach the same lung cancer risk level as non-smokers.
    a. 5-10
    b. 10-15
    c. 5
    d. 15-20
A

B

25
Q
  1. Which statement of small cell lung cancer is NOT true?
    a. Does not respond well to radiation therapy.
    b. The likelihood that it will return is high.
    c. One of the two main types is “oat cell cancer”
    d. Staging is either Limited or Extensive.
A

A

* Yes, it does respond well to radiation and chemo… it just comes back. Usually done for palliative care.

26
Q
  1. True/False: NSCLC has a “Stage 0” where the cancer is occult or hidden.
A

True

27
Q
  1. Paraneoplastic Syndrome can be caused by all of the following EXCEPT:
    a. cytokines
    b. hormones
    c. enzymes
    d. precise cell signaling
A

D
* we want cell signaling to be precise and an error free process – this is good/normal and wouldn’t cause the syndrome. Another cause is antibodies (produced by body in response to tumor) – these destroy healthy cells. Paraneoplastic Syndrome is often seen with SCLC’s and a lot of symptoms of the syndrome are seen even before the early symptoms of the lung cancer itself.

28
Q
  1. Which of the following is NOT a priority nursing goal for a lung cancer patient?
    a. maintain an effective breathing pattern
    b. ensure adequate airway clearance
    c. promote a realistic attitude about treatment and prognosis
    d. maintain adequate oxygenation of tissues
A

C

* a realistic attitude is important but not as important and breathing and oxygenation (ABC’s – Maslows 1st)

29
Q
  1. Later manifestations of lung cancer are typically all BUT which of the following?
    a. Fatigue
    b. shortness of breath (other early manifestations are persistent cough, blood tinged sputum, dyspnea, wheezing and chest pain)
    c. weight loss w/no known cause
    d. hoarseness
A

B
* anorexia, nausea and vomiting are also later symptoms. If lung cancer spreads to other parts of the body, it may cause: Bone pain (like pain in the back or hips)

N443 (7 decks)

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