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Test 4 > Respiratory Malignancies > Flashcards

Respiratory Malignancies Flashcards

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1
Q

Risk Factors for Head and Neck Cancer

List 11

A
  • Smoking
  • Alcohol
  • HPV
  • Gender: Men 2-3x more common
  • Age
  • Poor oral Hygiene
  • Occupational hazards
  • Marijuana use
  • GERD
  • Poor nutrition: weakens immune system
  • Weakened immune system
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2
Q

In young adult population, main risk factor is

A

HPV

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3
Q

A patient with a history of heavy alcohol use and newly diagnosed with head and neck cancer is admitted for surgery, what should the nurse monitor for?

A

Alcohol withdrawal

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4
Q

8 S/S of Head and Neck Cancer

A
  • Ear pain (otalgia)
  • Nose bleeds (epistaxis)
  • Coughing up blood (hemoptysis)
  • Difficulty swallowing (dysphagia)
  • Difficulty breathing (dyspnea)
  • White, patchy lesions (Leukoplakia)precancerous (does not heel after 2 weeks)
  • Red, patchy lesions (Erythroplakia)
  • Weight loss
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5
Q

Difinitive Dx study for Head & Neck Cancer

A

Biopsy

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6
Q

If patient has an ENDOSCOPY for dx studies, what should be monitored after procedure before allowing the patient to eat or drink.

A

Gag reflex- to prevent aspiration

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7
Q

System used by healthcare providers to determine cancer stage

A

TNM staging system

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8
Q

TNM stands for

A
  • Tumor: size of tumor
  • Node: Number and location of involved lymph nodes
  • Metastasis: Extent of metastasis (has it spread)
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9
Q

3 main treatments for Head and Neck Cancer

A
  • Chemotherapy & Targeted Therapy
  • Radiation
  • Surgery
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10
Q

Preferred treatments for Head and Neck cancer

A

Radiation + Chemo

(chemo on its own does not cure)

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11
Q

Review:

larynx is essential for

A

normal breathing
protecting the airway
producing sound (speech)

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12
Q

Surgical Treatment:

HIGHEST risk with Partial Laryngectomy

A

risk of aspiration

  • important parts of the throat that prevent food and liquids from entering the airway are removed. Since the airway is still connected to the mouth, there’s a higher risk of aspiration.
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13
Q

Which of the following surgical procedures results in no risk for aspiration?

A) Partial laryngectomy
B) Total laryngectomy
C) Tracheostomy
D) Esophagectomy

A

B) Total laryngectomy

-Since a total laryngectomy removes the entire larynx, separating the airway from the digestive tract, there is no risk for aspiration. (Separates esophagus and trachea)

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14
Q

Surgical Treatment:

What senses are LOST with a TOTAL Laryngectomy?

List 3

A
  • Normal speech ability is lost
  • Sense of smell: air no longer passes thru the nose when breathing, disrupting ability to smell
  • Sense of taste
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15
Q

After a total laryngectomy, what type of airway management will a patient require?

A

permanent tracheostomy

  • creates a NEW airway for breathing, as the removal of the larynx eliminates the normal route for air passage through the mouth and nose.
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16
Q

Surgical removal of lymph nodes and surrounding tissues in the neck to eliminate cancerous cells.

A

Radical Neck Dissection

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17
Q

What are the potential complications of a radical neck dissection that can affect a patient’s physical abilities and appearance?

A

Complications may include:
* difficulty lifting and turning the head
* shoulder drop on the affected side
* significant physical deformity

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18
Q

Radiation Therapy:

Involves delivering high-energy radiation beams from OUTSIDE the body directly to the tumor.

A

External beam

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19
Q

Radiation Therapy:

Involves placing radioactive sources directly INSIDE or very close to the tumor.

A

Internal implants (brachytherapy)

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20
Q

2 types of Internal Implants (brachytherapy)

A
  • temporary
  • permanent
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21
Q

Which type of the 2 types of Radiation Therapy is the patient radioctive

A

Internal implants (brachytherapy)

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22
Q

Review from N2:

2 types of brachytherapy based on the form of the radioactive material

A
  • sealed (or solid) brachytherapy
    -seeds, applicators
  • unsealed (or liquid) brachytherapy
    -injected,oral: systemically
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23
Q

Type of Brachytherapy where patient emits radiation but NONE in EXCRETIONS (waste products)

24
Q

Type of Brachytherapy where Patient AND Exretion are radioactive

25
Nursing Responsibilities for Patients receiving **Brachytherapy** tx. List 5
* **Private Room** for Pt * Limit visits **10-30 mins** * Visitors sit **6 ft away** from pt * **No** small children or pregnant women * Assess fistulas or necrosis of adjacent tissue * Monitor for S/S: burning, excessive perspiration, cills/fever, N/V, diarrhea
26
**Chemo and Radiation** (both) are used for which stages of cancers (all cancers)?
III & IV (3/4)
27
Used with **chemotherapy** for patients with **late-stage head and neck cancer**
Targeted Therapy & Immunotherapy
28
*Targeted Therapy & Immunotherapy*: These patients are at high risk for
infection
29
**Fever** that is an **EMERGENCY situation** for **chemo patients**
Fever of **100.4 F** **know**
30
With Head and Neck Cancers we are more concerned with: List 4
* Airway * Breathing * Bleeding * Infection
31
Can head and Neck cancers be prevented?
Most can! * stop tobacco and alcohol * poor oral hygiene * HPV infection
32
*Head & Neck Cancer*: Nursing Management for **Acute Care**
* Teach about the type of treatment **pre-op**. * Prepare them to deal with the **psychological impact of cancer** * Alteration in physical appearance * Possible need for **enteral feedings** * Potential for **altered methods of communication** * Assessment of the support system ( social service)
33
**Post-Op Care** for **Airway** Management
* **Inflammation** may compress the trachea * **Semi-Fowler’s position** to decrease edema * **Frequent suctioning via tracheostomy** for patients with laryngectomy * **Adequate fluids** to keep secretions thin and mucous membranes moist **
34
*Post-Op Wound Care*: **first dressing change** after surgery typically performed by
surgeon
35
*Post-Op: Nutrition * What clinical indicator suggests that a patient may begin enteral or oral feeding after surgery?
The return of bowel sounds.
36
What are important considerations for **pain control** in patients who may not be able to speak?
* Administer analgesic drugs as needed to manage pain effectively. * Use **visual cues**, such as the **FACES pain scale**, to help assess pain levels * Text-to-speech apps * Keyboard-based communication
37
High Mortality, Low cure rates What cancer am I?
Lung cancer
38
What is the **primary risk factor** for developing lung cancer?
smoking
39
What are the other 2 causes of Lung Cancer
* **Radon**: gas emitted from soil * **Occupational and environmental causes** (industrial pollutants, firefighters, coal miners)
40
Why is the **prognosis for lung cancer** generally **poor**?
due to **late diagnosis** and the frequent **presence of metastasis** at the time of detection.
41
**Most Common** S/S of **Lung cancer**
Chronic cough or Bloody cough
42
Early S/S of Lung Cancer
* Bone pain: *due to mestastasis near spine, rib cage, pelvis* * Wheezing sound * raspy, hoarse voice * SOB * Difficulty Swallowing: *metastasis tumors can hit nerves near esophagus*
43
2 **Late** S/S of **Lung Cancer**
* Unexplained Weight Loss * Nail Clubbing
44
**DX study** that is **DEFINITIVE** for Lung Cancer
Biopsy
45
What is the relationship between **lung cancer** and **superior vena cava syndrome?**
Lung cancer can cause superior vena cava syndrome (SVCS) * when a **tumor** compresses or invades the superior vena cava, **leading to obstructed blood flow**
46
What **symptoms** might indicate the **presence of superior vena cava syndrome** in a **lung** cancer patient?
* Facial swelling or puffiness. * Neck swelling or distention. * Shortness of breath or difficulty breathing. * Headaches or dizziness. * Prominent veins in the neck or chest
47
**2 Treatments** for Superior Vena Cava syndrome (SVC)
* Radiation therapy **with or without chemotherapy** is the mainstay of treatment for most patients. * **Intravascular stents** are proven to be safe and effective and allow the **most rapid resolution of symptoms**
48
What are **key components of respiratory status and care** for a patient **after lung cancer surgery**? List 5
* **Assessment of respiratory status**.- IMPORTANT * Proper **positioning** to facilitate breathing. * Use of an **incentive spirometer** * "**turning, coughing, and deep breathing"** (TCDB) techniques. * Effective **chest tube management** to ensure proper drainage and lung expansion.
49
How does **effective pain control** contribute to **preventing hypoventilation** in patients?
* When a patient has pain, it can be uncomfortable to take deep breaths or cough. * If the pain **isn't** managed well, the patient might avoid taking deep breaths * When they're not in pain, they’re more likely to take deep breaths and cough when necessary.
50
Repeted: Lung Cancer- **POST OP** **No. 1 Emergency Symptom**
**Fever 100.4 F** or greater. * Most reliable indicator for infection!! * check WBC!!!! IMPORTANT
51
What role does **early ambulation** play in **post-surgery** recovery?
Helps **prevent DVT and PE**, **improves circulation**, and **accelerates recovery**.
52
**Treament for Lung cancer** leads to several common symptoms. List 5
* Fatigue * Nausea/Vomiting * Anorexia * Cachexia: *wasting of body due to severe chronic illness* * Rashes * Alopecia (hair loss)
53
A condition characterized by the **collapse or partial collapse** of the **lung or a section (lobe) of the lung**.
Atelectasis
54
**Early** signs of **Atelectasis**
* Decreased breath sounds * Low grade fever
55
**Late** signs of **Atelectasis**
* cyanosis * intercostal retractions
56
Nutrition needed for Lung Cancer patients
high-calorie high-protein

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