Oncology: Dx & Tx Flashcards by Melissa Johnson

General S/S

What does CAUTION stand for?

Change in bowel/bladder habits
A sore that does not heal
Unusual bleeding/discharge
Thickening or lump in breast/elsewhere
Indigestion/difficulty swallowing
Obvious change in wart or mole
Nagging cough or hoarseness

How well did you know this?

Not at all

Perfectly

General S/S

What does C in CAUTION stand for?

Change in bowel/bladder habits

How well did you know this?

Not at all

Perfectly

General S/S

What does A in CAUTION stand for?

A sore that does not heal

How well did you know this?

Not at all

Perfectly

General S/S

What does U in CAUTION stand for?

Unusual bleeding/discharge

How well did you know this?

Not at all

Perfectly

General S/S

What does T in CAUTION stand for?

Thickening or lump in breast or elsewhere

How well did you know this?

Not at all

Perfectly

General S/S

What does I in CAUTION stand for?

Indigestion or difficulty swallowing

How well did you know this?

Not at all

Perfectly

General S/S

What does O in CAUTION stand for?

Obvious change in wart or mole

How well did you know this?

Not at all

Perfectly

General S/S

What does N in CAUTION stand for?

Nagging cough/hoarsenss

How well did you know this?

Not at all

Perfectly

General S/S

Cancer can invade bone marrow which leads to ___

Anemia (hypoxia)
Leukopenia (infection risk!)
Thrombocytopenia (bleeding precautions)

How well did you know this?

Not at all

Perfectly

General S/S

Unexplained ___

Weight loss

*cachexia

How well did you know this?

Not at all

Perfectly

General S/S

Fever is an early sign with ____

Leukemia

Lymphomas

How well did you know this?

Not at all

Perfectly

General S/S

What is the #1 symptoms that clients complain of with dx of cancer

Fatigue

How well did you know this?

Not at all

Perfectly

General S/S

Pain is an early sign of what cancers?

Bone, brain, testicular

Severe HA–possible brain
Back pain–possible colon, rectum

How well did you know this?

Not at all

Perfectly

Blood tests

What is abnormal?

CBC and differential

How well did you know this?

Not at all

Perfectly

Blood tests

Most concerned with what lab?

Neutrophils

How well did you know this?

Not at all

Perfectly

Blood tests

What is elevated?

Liver enzymes

How well did you know this?

Not at all

Perfectly

Blood tests

Other?

AST ALT

Tumor markers

How well did you know this?

Not at all

Perfectly

Positive dx studies? (7)

CXR
CT
MRI
PET
Bone marrow biopsy
Tissue biopsy
Imaging

How well did you know this?

Not at all

Perfectly

What is total laryngectomy?

Removal of vocal cords, epiglottis, and thyroid cartilage

How well did you know this?

Not at all

Perfectly

Total laryngectomy

This client will have permanent ___

Tracheostomy or laryngectomy (same things but trach is short term and laryngectomy is long term)

How well did you know this?

Not at all

Perfectly

Total laryngectomy

Post op HOB?

30-45

How well did you know this?

Not at all

Perfectly

Total laryngectomy

Why NG feedings?

To protect suture line (peristalsis can disrupt suture)

How well did you know this?

Not at all

Perfectly

Total laryngectomy

Monitor __

Drains

How well did you know this?

Not at all

Perfectly

Total laryngectomy

Watch for ____

Carotid artery rupture

How well did you know this?

Not at all

Perfectly

Total laryngectomy Frequent ___ care to decrease bacterial count

Mouth

Total laryngectomy NPO people are at risk for getting ___

Pneumonia

Total laryngectomy When the client leaves the hospital, a __ will be used to cover the trach because it acts like a filter

Bib

Total laryngectomy What environment helps

Humidified

Total laryngectomy All breathing is done how?

Through stoma

Total laryngectomy Can client talk?

No unless they are using electrolarynx or Blom-singer device

Total laryngectomy Can client whistle? Drink through straw? Smoke? Swim?

NO!! *although some still smoke even though that is NOT recommended!!

Goals of tx?

Cure Control Palliation

What is adjuvant therapy?

Two therapy used together (chemo and radiation)

What is neoadjuvant therapy?

Time specific (one before the next) surgery, then chemo

What is tx plan based on?

- Recommended tx plans for dx - Grade of cancer - What client wants!!!!

Why do surgery?

- Prevention (remove benign/pre-malignant tumors) - Dx (to stage/lymph node mapping) - Tx - Reconstruction (breast cancer)

Post op after mastectomy Bleeding--where to check dressings?

Front and back (blood can pool in the back)

Post op after mastectomy If reconstruction includes using their own tissue, they will also have ___ surgical site

Abdominal site *can harvest adipose tissue from other sites but abdomen is most common

Post op after mastectomy What draining system will they have?

Hemovac or Jackson Pratt

Post op after mastectomy What if lymph nodes were removed from one side?

Avoid this for LIFETIME of client!!!: - No BP - No blouses with elastic - No watch - No IV or injections on affected side *wear gloves when gardening, watch small cuts, no nail biting, no sunburns

Post op after mastectomy What helps promote circulation?

Brush hair Squeeze tennis ball Wall climbing Flex and extend elbow

What is internal radiation?

Brachytherapy

Brachytherapy (internal) is used to get the radiation ___ to the cancer or target tissue

Brachytherapy (internal) is internal so it is ____ the body

Inside! Brachytherapy is very CLOSE to target tissue bc radiation is inside body

With all types of brachytherapy (internal) the client emit ____ for a period of time and is a hazard to others

Radiation

Brachytherapy (internal) is either sealed or unsealed. What is unsealed? Ex? Radioactive?

Client and body fluids emit radiation EX: Radioisotope given IV or PO *radioactive 24-48 hrs

Brachytherapy (internal) is either sealed or unsealed. What is sealed/solid? Radioactive?

Client emits radiation but body fluids are NOT radioactive *can be temporary or permanent implant that is placed close to or inside tumor

Precautions with brachytherapy (internal) radiation How often to rotate nursing assignments? Why?

Daily so nurse isn't continually exposed *if you have radiation client, that is your ONLY client for that shift!!

Precautions with brachytherapy (internal) radiation What room?

Private

Precautions with brachytherapy (internal) radiation Nurse wear what?

Film badge at all times

Precautions with brachytherapy (internal) radiation Visitors

- Restrict visitors - Limit each to 30 min per day, must stay 6 feet from source - No visitors less than 16 years old - No pregs (visitors or nurses!!)

Precautions with brachytherapy (internal) radiation How to mark room?

With instructions for specific isotope

Precautions with brachytherapy (internal) radiation Wear what?

Gloves with risk of exposure to body fluids

Precautions with brachytherapy (internal) radiation How to prevent dislodgment?

- Keep client on bedrest - DECREASE fiber - Prevent bladder distention (put pt on catheter)

Precautions with brachytherapy (internal) radiation What if implant becomes dislodge. How to get it?

Gloves Pick up with forceps Put in lead container

Precautions with brachytherapy (internal) radiation After radiation? (5)

- Can sleep in bed with spouse/children (1-11 days) - Dont use public transportation - Dont return to work immediately - Dont share utensils/cook for others - Stay away from people (6 ft away at least!), esp children for 2-3 days at least

Precautions with brachytherapy (internal) radiation How to flush toilet?

Close lid and flush 2-3x each use

External radiation (teletherapy, beam) Radioactive?

External radiation (teletherapy, beam) SE?

Limited to exposed tissues * Erythema * Shedding of skin * Altered taste * FATIGUE * Pancytopenia

External radiation (teletherapy, beam) S/S are ___ and ___ related

Location and dose

External radiation (teletherapy, beam) Can you wash off markings?

External radiation (teletherapy, beam) How long to protect site from sunlight and UV exposure?

1 year after completion of therapy

External radiation (teletherapy, beam) What is this?

Focused beam or high energy rays deliver by a machine outside of the body