Oncology Flashcards
(70 cards)
1
Q
cancer (CA)
A
abnormal cell growth; cells ignore the growth regulation signals
2
Q
Benign
A
tumor that is noncancerous
3
Q
Malignant neoplasms (cancer cells)
A
cancer cell growth
4
Q
tumor
A
can be cancerous or noncancerous; abnormal tissue growth
5
Q
metastasis
A
spread of cancer from original site to another site
6
Q
what is the second leading cause of death?
A
cancer! second to cardiovascular disease
7
Q
3 leading causes of cancer death in men
A
prostate, lung, colorectal
8
Q
3 leading causes of cancer death in women
A
breast, lung, colorectal
9
Q
rates of cancer death are higher in men or women?
A
men
10
Q
cancer death rates are higher in which specific gender & race & lower is which specific gender & race?
A
higher: African American men
lower: Asian / Pacific Islander women
11
Q
factors affecting cancer death rates (4)
A
- attitudes / lifestyle choices
- cultural beliefs
- socioeconomic status / insurance coverage
- misconceptions
12
Q
what causes cancer?
- factors associated w cancer causation
- describe exposure
- list another cause
A
causes of most cancers are unknown
carcinogens: factors associated w cancer causation
exposure: alteration of genetic material of cell = oncogenes = produce abnormal cells = eventually become cancer cells
- failure of immune system can be another cause
13
Q
lung cancer is often associated with _____
A
smoking
14
Q
skin cancer is often associated with ____
A
UV light rays
15
Q
examples of controllable risk factors (preventable concerns for cancer)
A
smoking, tanning beds, wearing sunscreen
16
Q
list specific risk factors associated w increase incidence of cancer (4)
A
obesity, sedentary lifestyle, diet high in red meats & processed foods, diet high in alcohol
17
Q
list & briefly describe specific carcinogens (6)
A
- viruses (HPV, hepatitis)
- physical agents (smoking, exposure to chemicals)
- chemicals
- genetic / familial factors (Broca 1 & 2 genes)
- lifestyle factors (diet high in red meats, processed foods, alcohol)
- hormones (childbirth, menopause)
18
Q
role of the immune system R/T oncology (3)
A
surveillance, intact immune system, immune system invasion
19
Q
how is cancer cell division & cancer cells different from the normal cell cycle? which specific gene is lacked?
A
- complete the cell cycle quicker
- less likely to enter in G0 phase
- uncontrolled growth patterns & immortality (lack p 53 gene)
- rapidly growing & reproducing cells are the targets of chemo & radiation
20
Q
describe primary cancer prevention & give an example
A
reducing the risks
EX: HPV immunization
21
Q
describe secondary cancer prevention & give examples
A
early detection & screening
examples: screening efforts like inspection, palpation, & diagnostic tests
22
Q
describe tertiary cancer prevention
A
after diagnosis; prevention of complications
treatments considered therapeutic to eradicate or arrest disease and/or prevent further complications
23
Q
how is cancer diagnosed?
A
- multidisciplinary
- physical exam findings during examination
24
Q
diagnosis of malignancy (4)
A
- tissue biopsy
- cytology results
- lab results (hematological malignancies)
- CT, X-rays, MRI (scans body for tumors)
25
what must patients have to make cancer & malignancy diagnosis?
must have cells / tissue!!!
26
staging & grading of cancer
- when is it done?
- how are tumors categorized?
- Done immediately after diagnosis / prior to treatment
- Categorize tumors according to extent of disease & organs involved
27
describe staging vs grading
staging: determines the size, invasion, lymph node involvement, metastasis (how far it has spread); uses TNM system (tumor, nodes, mets)
grading: pathologic classification (Type of tumor cells & differentiation) Evaluation of extent to which tumor cells differ from normal cells
28
higher the stage or grade....
decreases prognosis for cure
29
higher the grade....
less chance of successful treatment
30
list & describe the stages of cancer
stage 0: in situ cancer / very early lesions (Bump that can be cut out)
stage I: early invasion / no metastasis; No lymph nodes involved
(All in one spot)
stage II: limited local extension of tumor / minimal node involvement; Involvement in muscle wall as well as an organ
(Deeply in one spot)
stage III: extensive local & nodal invasion (Deeply in one spot & lymph node involvement)
stage IV: distant metastasis / other organs involved
31
list & describe the grades of cancer
grades 1 & 2: well differentiated & deviated minimally from normal cells
"High grades" (grades 3 & 4): poorly differentiated & most aberrant compared w normal cells
32
list & describe the 2 cancer treatment goals
1. cure: eradictate the cancer
2. Palliation: alleviation of symptoms when disease is beyond treatment
33
describe surgery cancer treatment
- Primary treatment
- Palliative
- Prophylactic: Treatment done before even being diagnosed (kind of a prevention) usually if someone is at a high risk
- Used alone or with radiation & chemotherapy
34
goals of radiation therapy
cure, control (controlling the growth), prophylactic
35
prophylactic meaning
Treatment done before even being diagnosed (kind of a prevention) usually if someone is at a high risk for a type of cancer
36
radiation treatment affects rapidly dividing cells such as... (5)
1. Bone marrow
2. Lymphatic tissue
3. Epithelium of GI
4. Hair follicles
5. Gonads
37
describe the process of radiation dosage; what should patients be educated on?
- BSA (body surface area) often used
- Patients should be educated on trying not to lose a lot of weight due to accuracy for med dosage
38
list the 3 types of radiation
external beam, internal radiation (brachytherapy), radioactive isotopes
39
describe the external beam radiation
- source
- what does it provide?
- what is affected?
- can body tolerate it?
- how is it given?
- Source outside of body
- Provides direct hit for local treatment
- ALL tissue in pathway is affected
- Limited amount that body can tolerate
- Given in divided doses over several days or weeks
40
describe the internal radiation (bradytherapy)
- what also is this called?
- what type of source?
- also called radioactive implants / “seeds”
- Sealed source
- Site specific (prostate, thyroid)
- Little exposure to nursing staff
- No isolation needed
41
describe the radioactive isotopes radiation
- what type of treatment? how is it administered?
- what type of source?
- patient & body are ____
- what is required for staff?
- which type of precautions?
- Systemic treatment - inject / swallow
- Unsealed source
- ***Patient & body radioactive***
- Time, distance, & shielding for staff safety
- Body fluid precautions & Isolation precautions
42
adverse effects of radiation (4)
1. skin reactions at entry & exit site of beam (external beam)
2. bone marrow suppression
3. fatigue
4. alteration in nutrition - mucositis / stomatitis (inflammation of soft tissue in mouth - can be very painful)
43
how long can adverse effects of radiation take to begin & how long can they last?
***onset may take several days / weeks to begin & may last 2-4 weeks after treatment***
44
Nursing care of radiation (4)
1. skin care
- NO ointments, powder, soaps, deodorant, or perfumes
- NO shaving w razor blade
- protect skin from cold, heat, sun
- loose fitting clothing
- ONLY lotions, etc approved by radiology for skin irritations
- do NOT wash off markings
2. monitor CBC
3. manage symptoms
4. maintain nutrition
45
normal lab value of RBCs
men: 4.0 - 5.9
women: 3.8 - 5.2
46
Antineoplastic drugs
- what are they also known as?
- describe their function
- also known as chemo drugs
- work on rapidly dividing cells (but not smart enough to know which types are cancer cells) - why chemo destroys everything in the body!
47
list & describe the 4 principles of chemo
1. Disrupts reproduction of cells by altering biochemical processes
2. Destroys malignant cells w out excess destruction of normal cells
3. Given in repeated doses or cycles
4. Functional assessment & other clearance tests done before drugs begin
48
definition of chemotherapy
use of cytotoxic drugs
49
uses of chemotherapy (4)
1. If widespread / systemic disease
2. High risk of undetectable disease
3. Tumor cannot be resected & is resistant to radiation treatment
4. Primary or combination treatment
50
goals of chemotherapy (3)
cure, control, palliative
51
chemotherapy adverse effects - Hematopoietic changes (4)
1. Leukopenia (low WBC count)
2. Anemia
3. Thrombocytopenia (RBCs & platelets are low)
4. May interrupt treatment schedule
52
what is a common (but not as much anymore) adverse effect of chemotherapy that patients & families fear?
which med is given to prevent this?
Nausea & vomiting (Ondansetron is given)
53
chemotherapy adverse effects - Mucosiitis / Stomatitis changes (3)
1. oral, rectal, vaginal
2. can effect entire GI tract - severe diarrhea
3. can get ulcers in the mouth, GI tract, or rectum
54
chemotherapy adverse effects - skin (2)
1. Hair loss (alopecia)
- hair will return but not necessarily the same
2. skin reactions (finger nails & toe nails typically fall off)
55
which cardiac med is used in chemotherapy as a protectant?
Doxorubicin
56
which hepatic med is used in chemotherapy?
5-FU floraouracil
57
which 2 renal meds are used in chemotherapy?
what are nursing interventions for these meds?
Cisplatin & cytoxan
nursing interventions: need pre-hydration & Mg replacement
58
which 2 neurologic meds are used in chemotherapy?
Cisplatin & plant alkaloids (vincristine)
59
how does chemotherapy affect the reproductive system? (3)
1. dysfunction
2. sperm / egg banking
3. loss of libido
60
role of nonspecific biologic response modifiers - give an example
stimulate the immune system generally
(EX: BCG)
61
role of monoclonal antibodies - give an example
Destroy specific malignant cells & spare normal cells (Ex: Trastuzumab)
62
what are the 3 types of cytokines? describe each & give examples
1. Interferons - antiviral, antitumor, immunomodulatory
2. Colony stimulating factors - treats myelosuppression (Ex: erythropoietin, filgrastim)
3. Interleukins - immunomodulatory
63
nursing management of the chemotherapy patients (5)
1. Assess, educate, & evaluate patient / family understanding
2. Monitor labs & patient’s clinical status
3. Precautions r/t neutropenia, anemia, thrombocytopenia
4. Assess self-care needs / assistance
5. Nutritional needs
64
nursing management of fatigue of an oncological patient (5)
1. Teach energy conservation methods (Cluster care)
2. Encourage rest periods between activities
3. Educate on expected fatigue
4. Educate on support groups
5. Educate on safety precautions r/t weakness, falls, & driving
65
nursing management of pain of an oncological patient (3)
- can lead to ___
- what to monitor?
1. Pharm / non pharm treatment
2. Leads to anxiety
3. Monitor labs for med choice
66
nursing management of nutritional needs of an oncological patient (8)
- what to administer?
- meticulous oral care: what does it consist of?
- what type of foods?
- pain meds if ____
1. Administer antiemetics (***before and/or on schedule)***
2. Small frequent meals
3. Supplemental findings
4. Educate on taste & smell alterations
5. Meticulous oral care ***(rinses w/ sodium bicarb) - baking soda*** (High risk for mouth ulcers)
6. Pain meds if stomatitis (inflammation of the mouth)
7. Blood, non-acidic foods
8. Maintain nutritional needs
67
bone marrow suppression (neutropenia)
- increased frequency of __
- what is the cardinal symptom?
- how to prevent?
- staff must do what?
- may need which type of meds?
- what type of pain is expected & which meds are given for this pain?
- Increased frequency of infection (Symptoms of infection may not appear)
- Fever is cardinal symptom (>38)
- Meticulous HANDWASHING!!!
- ***Staff wears mask in room & place on patient when patient leaving room (check agency policy)***
- NO fresh flowers, fruits, vegetables, yogurt w/ active cultures
- May need colony stimulating factors
(G-CSF (filigrastim) - increases WBCs
- Bone pain expected - acetaminophen given (no NSAIDS!)
68
bone marrow suppression (anemia)
- characteristics
- what stimulates new production of RBCs?
- what to watch for?
- patient may receive ___
1. Fatigue & decreased O2 carrying capacity
2. Erythropoietin (Epoetin alfa) - stimulates new production of RBCs
3. Watch Hgb / Hct
4. May receive blood transfusions
69
bone marrow suppression (thrombocytopenia)
- what to monitor for
- what are patients not allowed to use?
- what may patients require?
- Monitor for bleeding & bruising (esp. GI / oral)
- No razors / toothbrushes, no aspirin products, &
no IM injections
- May require platelet transfusions
70
oncology complications (9)
1. Infection secondary to neutropenia
2. Septic shock
3. Pain
4. bleeding / thrombocytopenia
5. Hypercalcemia
6. Tumor lysis syndrome
7. SIADH
8. DIC (disseminated intravascular coagulopathy) - bleeding everywhere
9. Spinal cord compression
