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Flashcards in oncology Deck (48)
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1

risk factors

tobacco
alcohol + tobacco =cocarcinogenic
diet (low fiber, red meat, animal fat, nitrites, alcohol, preservatives and additives)
obesity
immunosuppressed
aging
African Americans then whites
heredity
ultra violet radiation
carcinogens
stress
chronic irritations

2

primary prevention r/t cancer

no smoking
exercise
good nutrition
normal body weight
alcohol limitation
vaccines
sunscreen

3

secondary prevention r/t cancer

breast self awareness
monthly breast self exams starting at age 20 on day 7-12 of menstrual cycle
yearly clinical breast exam over 40
age 20-39 clinical breast exam once every three years
mammogram at 40 annually
before mammogram avoid lotion, powder, and deodorant
pap age 21 every 3 years
colonoscopy at 5o every 10 years
fecal occult blood yearly at age 50

4

secondary prevention r/t cancer for males

yearly clinical testicular exams
testicular tumors grow fast so monthly self exams
digital rectal exam (PSA) over 50
colonoscopy at 50 and every 10 years
fecal occult blood yearly at 50

5

tertiary prevention r/t cancer

manage long term care
support groups
rehab programs

6

general s/s

CAUTION
change in bowel/bladder
a sore that wont heal
unusual bleeding/discharge
thickening or lump in breast or elsewhere
indigestion or difficulty swallowing
obvious change in wart or mole
nagging cough or hoarseness

invades bone marrow (anemia, leukopenia, thrombocytopenia)
unexplained weight loss (cachexia-- extreme wasting and malnutrition)
fever (early sign of blood cancer and lymphoma)
fatigue
pain (bone, testicular, brain)

7

blood tests r/t cancer

abnormal CBC and diff (neutrophils)
elevated liver enzymes (AST/ALT)
tumor markers (biomarkers)

8

positive diagnostic studies

chest xray
CT scan
MRI
PET scan
bone marrow biopsy
tissue biopsy
imaging studies

9

why is surgery used

prevention (benign)
diagnosis
treatment

10

total laryngectomy

removal of vocal cords, epiglottis, and thyroid cartilage
permanent trach or laryngectomy
mid fowlers post op
NG feedings to protect suture line
monitor drains
frequent mouth care to decrease bacterial count
humidified environment
use Blom-Singer device to talk
cannot whistle
cannot drink through a straw
can smoke but not recommended
cannot swim

11

reconstructive surgery

breast cancer common

12

post op mastectomy

bleeding- check dressings front and back (pooling of blood can occur)
abdominal sites can occur if they are using their own tissue
avoid procedures on arm of affected side if lymph nodes were removed (no constriction, no BPs, no blouses with elastic, no watch, no IV or injections, wear gloves when gardening, watch small cuts, no nail biting, and no sunburn)

brush hair, squeeze tennis ball, wall climbing, flex and extend elbow to promote circulation

13

internal radiation therapy

brachytherapy

used to get radiation close to tissue/cancer
inside the body
emits radiation for a period of time and is a hazard

sealed: emits radiation, body fluids not radioactive, temporary or permanent implant

unsealed: client and body fluids emit radiation, IV or PO, radioactive for 24-48 hours

14

precautions with internal radiation

nursing assignments rotated daily
only care for one client with radiation in a given shift
private room
film badge at all times
restrict visitors
30 minutes/day for visitors
visitors must stay 6ft
no visitors less than 16 yo
no pregnant visitors/nurses
wear gloves
private room
cannot use same bed, toilet, or utensils as others

15

how to prevent dislodgment of the implant

bedrest
decrease fiber
prevent bladder distention

16

what if implant gets dislodged

gloves
forceps to pick up the implant
place in lead-lined container
leave in room
call radiation department

17

external radition

tele therapy
eternal beam radiotherapy
delivered outside of the body
not radioactive
SE: erythema, shedding of skin, fatigue, pancytopenia (all blood components are decreased)
do not wash off markings
don't use lotion on markings
protect the skin from sun for 1 year after therapy
good skin care

18

action of chemo

eliminate or reduce cancer cells as they develop
specific chemo drugs-- attack a specific phase of cell development
cell cycle non-specific: drugs that work on all or any phase of cell development
work best on cells actively growing

19

precautions for administration of chemo

oral
IM
topical
IV
intracavaity
look up drug info before administering
chemo gown-coated to prevent contamination-change immediately if contaminated
two pairs of chemo drugs (one under gown and one over the gown cuff)
wear goggles/mask if worried about splashing
excreted for 3-7 days after administration

20

disposal of chemo

yellow rigid chemo waste container for sharps and IV

yellow waste bag for gown, gloves, and disposable items

wash with soap and water after removing gloves

21

manage chemo spills

hazard chemical spill
obtain spill kit and use all PPE for clean up

22

major complication of chemo

extravasation

23

patho of extravasation

given IV via central line
peripheral only if drug is push or infuses in less than an hour
a vesicant is a drug that if it infiltrates it will cause tissue necrosis

24

s/s of extravasation

pain
swelling
no blood return

25

treatment for extravasation

*** prevention
stop infusion and send for extravasation kit
stay with client

26

transplants

used for hematologic cancers

27

stem cell transplant

when stem cells are transplanted from the blood stream
given into a vein and settle in the bone marrow and produce healthy blood cells

28

bone marrow transplant

stem cells transplanted from bone marrow

29

GI r/t cancer

N/V
antiemetic meds (Ondansetron) given routinely first week of chemo

stomatitis (oral cavity very susceptible to irritation)

diarrhea (nutrition and fluid and electrolyte imbalance)

30

Ondansetron

blocks effects of serotonin (serotonin receptor antagonist)

all end in "ton"