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Nurs 230 Exam 3 > oncologic disorders > Flashcards

oncologic disorders Flashcards

1
Q

biology of cancer

A

cancer does not response correctly to signals to regulate cell proliferation/cell death

cells should go from immature to mature

cells should not dedifferentiate

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2
Q

development of cancer

A

intiation

promotion

progression

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3
Q

initiation

phase of cancer

A

mutation occurs

causes:
genetic
enviornmental factors

usually our body stops it at this phase

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4
Q

promotion

phase of cancer

A

altered cell proliferates (grows)

may be accelerated (smoking, high fat diet)

latent period occurs

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5
Q

progression

phase of cancer

A

growth, invasion, and metastasis

tumor increase in size and forms blood vessels

tumor cells detach and invade other tissues (metastasis)

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6
Q

types of neoplasm (tumor)

A

benign:
*well differentiated tumor
*localized (do not metastasize)(encapsulated)
*recurrence unusual after excision
*usually harmless

malignant:
*rapid growth
*metastasis common
*recurrence common

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7
Q

classification of cancer

A

site
histology (grading)
extent of disease (staging)

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8
Q

clasification by site

A

carcinoma:
*skin/glands/mucous linings

sarcoma:
*connective tissue
*muscle
*bone, fat

lymphoma/leukemia:
*blood/bone marrow

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9
Q

histologic grading and staging of cancer

A

histologic grading:
*amount of dysplasia (difference from normal cell)
*1-4 (4 is worst)

staging based on spread:
*extent/spread of disease
*0:in situ (unlikely to spread)
*I,II,III: growing/ may be in lymph nodes
*IV: metastasis (spread to other areas)

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10
Q

main sites of metastasis

A

brain and cerebrospinal fluid:
*headaches

lung

liver:
*jaundice

Adrenals:
no symptoms

bone:
fracture without a fall

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11
Q

cancer preventions

A

primary

secondary

tertiary

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12
Q

primary prevention ***

A

p=prevent

dont have cancer yet

physical activity
diet recommendations
sunscreen
limit ETOH (2 drinks or less/day men and 1 for women)
HPV vaccination (cervical and neck cancer)

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13
Q

secondary prevention ***

A

early detection/screenings

middle of getting it or having

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14
Q

tertiary prevention ***

A

management of disease

attempts to slow progression
*tx

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15
Q

breast cancer screening ***

A

mammogram (gold standard)

clinical breast exam

self breast exam

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16
Q

colon cancer screening ***

A

colonoscopy

FIT test (fecal immunochemical testing)
*if positive then colonoscopy

multitarget stool DNA testing
*ex: cologuard

stool guiac
*from stool sample

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17
Q

prostate cancer screening ***

A

high incidence of false positive

PSA (blood test) is the only test
*prostate specific antigen

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18
Q

testicular cancer screening ***

A

age 20-40 y/o monthly self ecam

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19
Q

cervical cancer screening ***

A

PAP: age 21-29

HPV testing: age 30-65

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20
Q

lung cancer screening ***

A

low dose chest CT

pack years: #yrs smoked x packs/day

21
Q

warning signs of cancer ***

A

CAUTION
C=change in bowel/bladder habits
A=a sore that does not heal
U=unusual bleeding/discharge
T=thickening or lump in breast or elsewhere
I=indigestion or difficulty swallowing
O=obvious change in wart/mole
Nagging cough or hoarseness

22
Q

skin cancer

A

ABCDE
Asymmetry
Border
Color
Diameter
Evolution

23
Q

cancer diagnosis ***

A

biopsy: collecting cells and looking under microscope

PET scan: shows places of high metabolic activity
*tells us we have spread or metastasis

invasive procedures: if you have to do surgery to get biopsy

24
Q

cancer treatment goals ***

A

cure (eradicate)

control (slow progression)

pallitation (alleviate symptoms)

25
cancer treatment
main: surgery chemo radiation immunotherapy and target therapy bone marrow transplant
26
surgery for cancer
cure: remove tumor ex: thyroidectomy palliative: help manage symptoms, alleviate pain ex: feeding tube to maintain nutrition
27
chemotherapy Types of tumors Types of tx What it does
mainstay for solid tumors and hematologic cancers can use for cure or palliation disrupts the cell cycle systemic adverse effects
28
chemo administration ***
must be trained/certified PO, IM, IV, topical *IV most common (big risk of extravasation) regional administration: *intraperitoneal *intrathecal (injected into subarachnoid space for CNS) *intravesicular (into bladder via f/c)
29
effects of chemo on normal tissue Acute Delayed Chromic
acute toxicity: during and after admin *anaphylaxis, hypersensitivity, extravasation, N/V delayed effects: numerous *N/V, alopecia, rashes, bone marrow suppression, diarrhea/constipation chronic toxicities: damage to organs *heart, liver, kidneys, lungs
30
hematologic effects of chemo
bone marrow suppression *neutropenia (infection) *thrombocytopenia (bleeding) *anemia (bad perfusion/fatigue) usually lowest 7-10 days after chemo
31
radiation therapy External Internal
high energy beams damage DNA -cell death external beam: most common * exposed to radiation from tx machine internal radiation (aka brachytherapy) *radioactive material goes into pt *pt can emit radiation *sealed source: stays where you put it (do not touch) *unsealed: IV/oral radiation drug (bodily fluids are contaminated
32
radiation safety for internal radiation
-reduce time -keep distant -shielding (lead shields) -caregivers should wear film badge (patch to turn colors if exposed to too much radiation) -NO pregnant staff should care for these pts
33
fatigue
multifactorial *anemia *insomnia *depression/anxiety *dehydration tx: balance rest/activity
34
GI effects to radiation and chemo
anorexia: *nausea, stomatitis (inflammation of mouth), appetite suppressant tx:monitor wt, small freq meals, topical analgesia for stomatitis consitpation: tx: stool softeners, high fiber, fluid intake, activity Diarrhea: replace fluids N/V: prophylactic tx before sessions
35
skin effects: alopecia
2-3 weeks after first tx may or may not grow back may grow back different interventions: support groups avoid excessive shampooing wigs, scarves
36
skin effects radiation
photosensitivity *protect from sun 1 year *soft clothing skin reactions: ranging from mild rash to second degree burn *avoid extreme temps *gentle soaps/detergent
37
other effects
neuro: chemo brian peripheral neuropathy pulomnoary: pulmonitis cardiac: dysrhythmias reproductive: may lose fertility *discuss preservation of ova/sperm
38
cancer pain management
undertreatment is common inadequate assessment is Huge barrier *VS/ nonverbal signs of pain are not reliable in chronic pain *always believe pt management: Nsaids Opioids nerve blocks, epidural anesthesia
39
self care
coping strategies family support palliatige care/hospice
40
hematopoietic growth factors
colony stimulating factos to stimulate plts, neutrophils or macrophages ex: filgrastim (neupogen)=stimulate WBC production Oprelvekin (neumega)=stimulate plt production epoeitin (procrit) stimulate RBC production *most common (helps with fatigue)
41
biologic response modifiers
create environmet that is not conducive for cancer cells to grow (stimulating immune system) attack cancer cells directly (ex: monocolonal antibodies-attack specici antigens)
42
hematopoietic stem cell transplantation
high dose chemo to clear the bone marrow *healthy stems then transplanted autologous: pt own stem cells syngeneic: identical twin allogenic: from a donor used to treat: leukemia, multiple myeloma, lymphoma
43
harvest procedures: 2 methods
bone marrow aspiration: going to bleed and have pain under local anesthesa taken from iliac crest higher risk from peripheral blood
44
complications of treansplace of hematopoietic stem cells
graft vs host disease pancytopenia until transplanted marrow begins to work (2-4 weeks) *high risk of infection (will be in isolation)
45
spinal cord compression
cause: cancer in epidural space or spinal cord s/s: -back pain, verebral tenderness -motor weakness/sensory loss -autonomic dysfunction (bowel/bladder) *(looks like retention or incontinence) management: ER, radiation/surgery
46
superior vena cava syndrome
obstruction of superior vena cava by tumor s/s: facial/periorbital edema distention of veins of head, neck, chest HA, seizures mediastinal mass on CXR management: ER radiation at site more sensitive chemo
47
hypercalcemia
metastatic disease of bone or multiple myeloma *causes release ca from bone s/s: fatigue/weakness hyporeflecia cardiac dysrhythmias kidney stones management: hydration (dilute it) bisphosphates diuretics
48
tumor lysis syndrome
rapid release of cellular contents (tumor open up and the intracellular electrolytes get out) hallmark signs: hyperuricemia (gout) hyperphosphatemia hyperkalemia hypocalcemia watch for cardiac due to these within 24-48 hours after starting chemo management: hydration allopurinol (decreases uric acid) electrolyte correction

Nurs 230 Exam 3 (6 decks)

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