Test 2 Flashcards
(233 cards)
1
Q
Written procedures posted at every machine
Required by some state regulatory agencies
Know where emergency offs and circuits are
A
Emergency procedures
2
Q
Where machine is controlled
Monitor and control linac
Audio and visual
A
Control console
3
Q
4 states of operational status
A
Stand-by
Preparatory
Ready
Beam on
4
Q
Machine in “napping” state
Has time delay before it turns on
Keeps electronics warm
A
Stand-by
5
Q
Shows programmable operational status; record and verify
A
Preparatory
6
Q
Confirmed program information
A
Ready
7
Q
Turn key and hear “chirping” sound
A
Beam on
8
Q
Displayed before or during treatment
Designed to protect patient, employees, and equipment
A
Interlocks
9
Q
____ Gy (_____ cGy) can be given in 0.3 seconds at 4000 Gy/min if machine set for wrong beam energy
A
2 Gy (200 cGy)
10
Q
8 examples of interlocks
A
Beam energy Beam symmetry, flatness Dose rate, typical dose Mechanical hazards Carousel rotation for different treatment Bending magnet not steering correctly (BMAG) Foil fault Dose/MU 1.2
11
Q
11 new technologies
A
Conformal therapy Multileaf collimation (MLC) Dynamic wedge collimator Electronic portal imaging (EPID) On board imagers (OBIs) Stereotactic radiation therapy IMRT Tomotherapy Image guided radiation therapy (IGRT) Electronic arcs Flattening-field free (FFF)
12
Q
Took place of cerrobend blocks; 52-160 leaves made of tungsten
Usually rounded on edges so they don’t break if they hit leading to penumbra at end/tip of leaf
A
Multileaf collimation (MLC)
13
Q
Older; gets more conformal to tumor volume because peripheral dose decreases, tightens everything up to tumor volume
More angles = les dose per field; more beams
Field shape and beam angle change while gantry moves around patient
Allowed by IGRT
“Forward planning” process
A
Conformal therapy/3D-CRT
14
Q
Flat panel MV receptor across from gantry that gives image; demonstrate poor image quality/contrast
A
Electronic portal imaging (EPID)
15
Q
kV images on lateral sides of machine, correlates with interaction
Can recreate cone beam CT every 1 degree
Flat panel detector
Offers better detailed image
A
On board imagers (OBIs)
16
Q
High dose per fraction for hard to reach areas (brain); long prep time, precise
External 3D frame halo: bolts drilled into head and fastened to apparatus that prevents head movement
Planning can take 3-8 hours
Fiducials track movement
Brain tumors, anterior or venous malformations (AVM), etc.
A
Stereotactic radiation therapy
17
Q
Beam arrangements are tested by trial and error until satisfactory dose distribution is produced
A
“Forward planning” process
18
Q
IMRT develops treatment plans using this treatment planning; radiation oncologist selects dose parameters for normal tissues and the target volume and computer “back calculates” the desired dose distribution and beam arrangements
A
“Inverse treatment planning”
19
Q
How much dose is being received within lines
A
Isodose lines
20
Q
Beams in different planes
A
Non-coplanar
21
Q
Smaller MLC’s used for SBRT/SRS to conform the dose to very small treatment volumes receiving larger or single fraction doses
A
Micro-/mini-MLCs
22
Q
Curved to match beam divergence; took place of cerrobend blocks
A
Dynamic wedge collimator
23
Q
3 major components of the linac
A
Drivestand
Gantry
Couch
24
Q
Collimation: bimodal (open or shut), static
Similar to CT but 6 MV
Very conformal but limited
A
Tomotherapy
25
Similar to tomo arcing around
| More arcs = more time, patient has to stay still the whole time
Electronic/rapid arcs
26
2 types of IGRT
Exac trac
| CT overlay
27
Uses infrared tracking to see reference position
Exac trac
28
Makes sure patient is perfectly aligned and if there are any shifts to be made
CT overlay
29
Changing planning right there
Adapted planning
30
Real-time MRI with Co-60
Viewray
31
Computers used to assist therapist in the verification of treatment parameters allow incorrect setup parameters to be corrected before machine is turned on
Computer-assisted setup and recording of patient data reduces erros
Patient information comes from treatment planning computer to machine
Record and verify
32
2 classes of hazards defined by the FDA
Class I
| Class II
33
Accident causes death or injury
Class I
34
Accident if risk of serious injury low (operator error, linac error, etc.)
Class II
35
Dmax depth for superficial and orthovoltage
0.0 cm
36
Dmax depth for Cesium 137 and Radium 226
0.1 cm
37
Dmax depth for Cobalt 60
0.5 cm
38
Dmax depth for 4 MV
1.0 cm
39
Dmax depth for 6 MV
1.5 cm
40
Dmax depth for 10 MV
2.5 cm
41
Dmax depth for 15 MV
3.0 cm
42
Dmax depth for 18 MV
3-3.5 cm
43
Dmax depth for 20 MV
3.5 cm
44
Dmax depth for 25 MV
5.0 cm
45
Traditional and SI unit of Cobalt 60
Traditional: Ci
SI: Bq
46
Most sources have an activity of ____-____ Ci
750-9000 Ci
47
To compensate for the reduction in beam output of Co-60 each month (1%), a correction factor of about ___% per month must be applied to the output
1%
48
Electronic equilibrium
Dmax
49
Shielding for Co-60
Cerrobend melts at a much lower point than lead and is therefore easier and safer to use (cadmium)
50
5 methods to expose the Co-60 source
```
Air pressure (piston)
Rotating wheel
Mercury reservoir
Chain driven
Moving jaws
```
51
Number of HVLs formula
(1/2)^n = percent transmitted
52
Ratio of cerrobend to lead
12:1
53
2 advisory agencies that don't set regulations for radiation safety procedures
International Commission on Radiological Protection (ICRP)
| National Council on Radiation Protection and Measurements (NCRP)
54
Agency that sets regulations for radiation safety procedures
Nuclear Regulatory Commission (NRC)
55
States that enter into agreement with NRC to assume responsibility of enforcing regulations for ionizing radiation
Agreement states
56
3 times full calibration must be done
Sources replaced
5% deviation during QA or spot check
Any major repairs that require removal or restoration of major components
57
5 things full calibration includes
Radiation field-light coincidence
Timer accuracy
Distance measuring devices (ODIs, etc.)
Uniformity of radiation field and dependence based on useful beam
Exposure and dose rate for +/-3% accuracy for multiple field sizes
58
Average leakage and leakage for 1 reading at 1 m
Average = 2 or less mR/hr at 1 m
| 1 reading at 1 m = 10 or less mR/hr
59
Max permissible leakage in "on" position
0.1% or less of useful beam 1 m from source
60
Filter paper wiped on collimator edges twice a year with long forceps should read less than 0.005 microcurie
Wipe test
61
18-24 in bar to push source back into machine; first 7 in red = pretty safe, 2nd 7 in yellow = source back in housing
T-bar
62
Why dose Co-60 have very high penumbra?
Large source size
63
Increasing energy _______ penumbra; by over 10 MV penumbra _______ again because of Compton
Increases
64
Occurs with straight blocks because of divergence
Transmission penumbra
65
Transmission + geometric penumbra
Physical penumbra
66
Penumbra formula
P = S(SSD+d-SDD)/SDD
67
Increasing SSD and distance from source ______ penumbra; increasing SDD _______ penumbra
Increases, decreases
68
Who insures radiation therapists?
Hospital
69
Discipline dealing with what's good and bad, moral duty and obligation
Set of moral principles or values
Theory or system of moral values
Principles of conduct governing an individual or group
Foundation of law
Ethics
70
Fidelity to conscience; person's concept of right or wrong as it relates to conscience
Morality
71
Loyalty, faithfulness
Fidelity
72
Sum of rules and regulations by which society is governed in any formal and legally binding manner
Legal concepts
73
Foundation of which is ethics, primarily concerned with the good of a society as a functioning unit; exist so we can all live and coexist in formal and legal binding manner we're governed by
Doesn't consider the professional and patient to be on equal terms; greater legal burden/duties are imposed on the healthcare provider
Laws
74
Application of ethics to the bioethical sciences, medicine, nursing, and healthcare
Bioethics
75
7 principles of bioethics
```
Autonomy
Beneficence
Confidentiality
Justice
Nonmaleficence
Role fidelity
Veracity
```
76
Patients are independent actors whose freedom to control themselves is to be respected without interference from others
Autonomy
77
Healthcare professionals act in the best interest of patients, even when it might be inconvenient or sacrifices must be made
Beneficence
78
Principle that relates to the knowledge that information received by a patient to a healthcare provider or learned in the course of a healthcare provider performing their duty, is private and should be held in confidence
Confidentiality
79
Fairness and equity maintained among individuals
Justice
80
Directs professionals to avoid harmful acts to patients
Nonmaleficence
81
Principle that reminds professionals that they must be faithful to their role in healthcare environment
Role fidelity
82
Truthfulness specific within healthcare aspect
Veracity
83
3 groups of ethical theories
Teleology/consequentialism
Deontology/nonconsequentialism
Virtue ethics
84
2 forms of teleology/consequentialism
Egoism
| Utilitarianism
85
Evaluate good versus bad way person can provide greatest good for most people; ends justify the means
Teleology/consequentialism
86
Best long-term interests of an individual are promoted; in evaluating an act/action for its moral value, it must produce a greater ratio of good over bad for the individual
Egoism
87
Ethical behaviors should be geared toward performing acts that produce the greatest ratio of good to bad
Utilitarianism
88
Uses formal rules for right and wrong for solving problems; duty and right actions to be taken
Deontology/nonconsequentialism
89
Practical wisdom for emotional and intellectual problem solving; practical reasoning and consideration of consequences
Virtue ethics
90
Ways of viewing relationship with patient; use all of these to build a relationship with patient
Models for ethical decision making
91
5 models for ethical decision making
```
Engineering/analytical
Priestly
Collegial
Contractual
Covenant
```
92
Dehumanizing approach identifies caregivers as scientist dealing only in facts and doesn't consider the human aspect of the patient/disease
Engineering/analytical model
93
Provides caregiver with godlike attitude forcing patient to do whatever caregiver says regardless of pain
Priestly model
94
Presents a more cooperative method of pursuing healthcare for both provider and patient; consideration
Takes the extra time to get acquainted with patient
Collegial model
95
Maintains a business relationship where information and responsibility are shared; informed consent
Contractual model
96
Recognizes areas of healthcare not always covered by a contract; deals with an understanding between patient and healthcare provider that's often based on traditional values and goals
Go above and beyond to make sure patient gets best treatment; caregiver makes more decisions
Ex: give patient dietary needs, maybe even dietician if necessary
Covenant model
97
Be truthful and give factual information to patient; patient must be competent
Written; must be done before touching patient
Informed consent
98
4 things the patient must be informed of to give informed consent
The nature of the procedure, treatment, or disease
The expectations of the recommended treatment and the likelihood of success
Reasonable alternatives available and the probable outcome in the absence of treatment
The particular known risks that are material to the informed decision about whether to accept or reject medical recommendations
99
Document from American Hospital Association (AHA) that explains expectations when in hospital (confidentiality,etc.)
Patient Care Partnership
100
7 stages of grief cycle
```
Shock
Denial
Anger
Bargaining
Depression
Testing
Acceptance (DABDA)
```
101
Initial reaction to hearing news of bad event
Shock
102
Pretending what is, isn't
Denial
103
Outward demonstration of pent-up emotion and frustration
Anger
104
Trying to find a way out of the situation
Bargaining
105
Realization of facts
Depression
106
Searching for realistic resolutions
Testing
107
Coping with the situation and finding a way forward
Acceptance
108
Allows the competent adult to provide direction to healthcare providers concerning their choice of treatment under certain conditions should the individual no longer be competent by reason of illness or other infirmity to make those decision
Takes legal obligation from physician/hospital
Executes patient's wishes (ex: resuscitation)
Living will
109
Joint Commission requires every hospital to have a no code policy
Do-not-resuscitate (DNR)
110
5 things that must be done before executing a living will
Individual demonstrates competency at the time
What done if they code
Pain medications (religion)
Relieves hospital and physician of legal responsibility
Signature has to be witnessed by two disinterested individuals who aren't related, mentioned in will, or have no claim on the estate
111
Represents an intermediate station for patients with terminal illness between life and death
Daily care to make sure patient is comfortable in passing
Physical, moral, and emotional support
Improve and make patients life as tolerable as possible for little time they have left
Patients may enter on their own or may be referred by family, physicians, hospital-affiliated continuing care coordinators and social workers, visiting nurses, friends, or clergy
Life expectancy of 6 months or less
Most families prefer homecare
Hospice
112
Law that governs non-criminal activity, relationships between individuals
Civil laws
113
Type of civil law, wrongful act committed against a person
| Allows compensation to be paid to an individual damaged or injured by another
Tort
114
2 types of torts
Intentional
| Unintentional
115
Willful acts meant to be done
Intentional tort
116
Those acts that aren't intentionally harmful but still result in damage to property or injury to person
Ex: failure of healthcare provider to provide properly for the safety of a patient or failure to properly educate a patient, resulting in harm
Unintentional tort
117
7 intentional torts
```
Assault
Battery
False imprisonment
Libel
Slander
Invasion of privacy
Negligence
```
118
Threat of touching in an injurious way
Assault
119
Actual act of harmful, unconsented, or unwarranted contact with an individual
Battery
120
Intentional confinement without authorization by a person who physically constricts another with force, threat of force, or confining clothing or structures
False imprisonment
121
Written defamation of character
Libel
122
Oral defamation of character
Slander
123
Charges may result if confidentiality of information hasn't been maintained or the patient's body has been improperly and unnecessarily exposed or touched
Invasion of privacy
124
Neglect or omission of reasonable care or caution
Negligence
125
Failure to follow appropriate standards of care
Medical negligence/malpractice
126
4 legal doctrines
Doctrine of Personal Liability
Doctrine of Respondeat Superior
Doctrine of Res Ipsa Loquitur/"the thing speaks for itself"
Doctrine of Foreseeability
127
Persons are liable for their own negligent conduct; law doesn't permit wrongdoers to avoid liability for their own actions, even though someone else may also be held liable for the wrongful conduct
Therapists can be held responsible for their own negligent actions
Doctrine of Personal Liability
128
An employer is responsible for negligent acts of employees that occur while they're carrying out the orders or serving the interests of the employer; certified, come from accredited program, etc.
Doctrine of Respondeat Superior
129
Requires the defendant to explain the events and convince the court that no negligence was involved; the Standards of Practice for Radiation Therapists may be used by either the defense of the prosecution to support or refute negligent behavior
Doctrine of Res Ipsa Loquitur/"the thing speaks for itself"
130
Principle of law that holds an individual liable for all natural and proximate consequences of negligent acts to another individual to whom a duty is owed
The negligent acts should or could have been reasonably foreseen under the circumstances
Injury suffered must be related to the foreseeable injury
Doctrine of Foreseeability
131
Believed to be the key element in loss prevention from adverse medical incidents and links every quality improvement program with measurable outcomes
Tolerances, determine effectiveness with consideration to patient's safety
Risk management
132
Any happening that isn't consistant with the routine operation of the hospital or the routine care of a particular patient
Incident
133
7 rationales for and documentation of treatment
Written patient history, radiographic results
Patient progress
Notes from weekly treatment visits
Blood counts, weights
Treatment indicators/responses
Why patient's being treated the way they are
Written and included in patient's chart
134
Kept separate/in department from patient's individual medical records
Patient's name and hospital ID number on each page
Should be legible and in pen
If mistake made, cross it out with one line and initial and date it
QA: ID, consent, diagnostic dictations, etc.
Radiation therapy chart
135
Consolidate, organize, and document an individual's healthcare experience
Demonstrates why patient's being treated
Medical records
136
Computer-hosted medical record provides collection and storage of information and facilitation of the patient encounter by providing the clinician with the most relevant information for the specific task at hand
Electronic medical record (EMR)
137
Focuses on total/overall health of patient, cross the lifetime of individuals; provides complete and accurate information and easier/better access to their information and gives patient empowerment (have access and can share as needed)
Electronic health record (EHR)
138
Assembly of tasks performed to accomplish a goal, can be very simple or complex
Workflow
139
Online management of the entire order tracking and documentation process from order entry to return of results and is a standard workflow component of an electronic chart
Computerized physician online order entry (CPOE)
140
4 input methods
Keyboard and mouse
Speech/voice recognition systems
Peripheral devices
Direct communication
141
4 peripheral devices
Barcodes
Biometric devices: fingerprint/retinal scanners
Cameras and scanners
Electronic completion devices: signature pads
142
Provides overall viewpoint/picture of health in certain country; took charge of publishing mortality classifications (1950s)
World Health Organization (WHO)
143
Set up standards to code and tabulate mortality and morbidity data
Made easy to calculate statistics (ex: cell type, classifying diseases, cause of death, level of pain)
International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD)
144
Step-by-step process for how something should be done
Finite set of instructions used by computers to compute a desired result (ex: diagnosis code and tumor size, node, and metastatic state data can calculate disease stage which saves clinician time)
Can compare medications and patient allergies; can be simple or complex
Treatment-planning computers
Algorithm
145
Stores and transfers images
Picture Archiving and Communication System (PACS)
146
Refers to graphic, textual, and auditory information the program presents to the user and the input methods the user employs to control the program; what is seen, usability of system
User interface
147
2 interfaces
Proprietary
| Standards-based/open systems development
148
Developed and owned by private or commercial entities; for sale/not free, widely used in radiation oncology (ex: Varian linac)
Drawback: duplication of effort with solving of common problems in unique ways
Proprietary interfaces
149
Developed by national and international committees accredited by organizations such as the American National Standards Institute (ANSI) or International Standards Organization (ISO)
Standards-based interfaces/open systems development
150
2 examples of standards-based interfaces/open systems development
Health Level 7 (HL7)
| Digital Imaging and Communications in Medicine (DICOM)
151
Defines comprehensive framework and standards for the exchange, integration sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery, and evaluation of healthcare services
Enable sharing of patient information useful across entire healthcare facility
Health Level 7 (HL7)
152
20 standards specific to imaging and transferring this information, used for PACS
Produced by National Electrical Manufacturers Association (NEMA) and the ACR
Describes each type or information that may be transferred
Digital Imaging and Communications in Medicine (DICOM) 3
153
Each type or information that may be transferred
Information Object Definitions (IOD)
154
6 IODS
```
Radiation therapy (RT) image
RT dose
RT structure set
RT plan
RT beams and RT brachytherapy
RT treatment summary
```
155
Conventional and virtual simulation images, DRRs, and portal images
Radiation therapy (RT) image
156
Dose distributions, isodose lines, dose-volume histograms (DVH)
RT dose
157
Plot of target or normal structure volume as function of dose
Dose-volume histograms (DVH)
158
Volumetric contours drawn from CT images
RT structure set
159
Text information that describes treatment plans, including prescriptions and fractionation, beam definitions, and so forth
RT plan
160
Treatment session reports for external beam or brachytherapy may be used as part of a record and verify (V&R) system
RT beams and RT brachytherapy
161
Cumulative summary information may be used after treatment to send information to a hospital EMR
RT treatment summary
162
A system of independent, interconnected computers or terminals communicating with one another over a shared medium, consisting of hardware and communication protocols; requires special hardware, including cards within the computers and particular cables
Network
163
Most common protocol
Ethernet
164
Formed to improve computerized systems in radiation oncology; provides a platform for the radiation oncology team, administrators, and industry representatives to address these issues and develop solutions that ensure the clinic delivers the most optimal care
Integrating the Healthcare Enterprise for Radiation Oncology (IHE-RO)
165
3 networks
Local area network (LAN)
Wireless local area network (WLAN)
Wide area network (WAN)
166
A network geographically confined to an area in which a common communication service may be used (ex: home, school, office, etc.); can implement EMR software
Local area network (LAN)
167
Allows users to connect to a local area network via a wireless connection
Wireless local area network (WLAN)
168
Uses telephone, T1 lines, T3 lines (T1 moves more data than T3, both expensive) or internet for larger geographic areas or multiple LANs
Wide area network (WAN)
169
Allows one to have applications and data stored off-site and maintained by this
Users access this information through secure and private internet connections; makes charts available from any internet connection
Implements EMR software
Provides server that can house a lot of information as opposed to a system and can be accessed anywhere with secure systems
Application service providers (ASPs)
170
Most common method of restricting access
Passwords
171
Require security precautions to not only restrict access but also keep records of who is accessing information
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
172
Organization, analysis, management, and use of information in healthcare
Medical informatics
173
Combines all the EMR information with scientific evidence, helps define clinical care for the patient
Evidence-based care
174
Reduce disease and promote health through communities
National public health agencies
175
3 national public health agencies
National Institutes of Health (NIH)
Food and Drug Administration (FDA)
Centers for Disease Control and Prevention (CDC)
176
Provide research to combat disease
National Institutes of Health (NIH)
177
Ensure safety of food, cosmetics, pharmaceuticals, biological products, and medical devices (linacs)
Food and Drug Administration (FDA)
178
Work with states and other partners to help observe disease, surveillance
Bioterrorism
Implement disease-prevention strategies and maintain national health statistics
Main purpose: provide and increase security if health within nation
Centers for Disease Control and Prevention (CDC)
179
Information system designed for the collection, management, and analysis of data on people with the diagnosis of cancer
Cancer registry
180
Data-gathering process in cancer registry
Abstracting
181
3 classifications of cancer registries
Health care institution registry/hospital-based
Central registries
Special purpose registries
182
Focuses on all patients who are diagnosed or treated for cancer within a specific center
Don't distinguish where patient is from and institution must follow everyone who passes through its doors
Tracking required by law to be passed up to a state or central agency
Health care institution registry/hospital-based
183
Compilations of all the healthcare institution registries that are then broken down by specific geographic areas
Show larger scale trends than individual cancer centerq
Central registries
184
Maintain data regarding a particular type of cancer, can be established if initial data at institutional or central level point toward potential trends
Special purpose registries
185
Boost
Cone down (CD)
186
Anatomical site to be treated/diagnosis, total dose (TD), daily or by-daily (BID) fractions, number of fractions/c, schedule of treatment, treatment technique/modality (photons, electrons, etc.), beam energy, port size/field size, angles/entry of angles or number of arcs, beam modifiers (block, wedges, bolus, etc.), patient position, signature and date by physician
Prescription
187
Time over which TD is delivered
Protractions
188
Date of treatment, treatment number, elapsed days (ED), daily dose, total dose, portal films, cumulative dose (CD)
Dated and signed by therapist
Can keep critical structures dose; helps keep track of changes (ex: boost, change in tumor size)
Daily treatment record
189
Most common charting error
Addition and transcribing
190
Portal films done on a minimum ______ basis
Weekly
191
2 errors
Systemic
| Random inherent variations in daily setup such as positioning, movement, etc.
192
Variation in the translation of the treatment setup from simulation to treatment unit
Systemic error
193
Take first exposure with 1-2 MU and open up collimation to take second exposure with less MUs or use OBI (kV) to see blocked field and organs behind it
Double-exposure film
194
Calculations must be checked _____
Twice
195
2 verbal cues
Cognitive
| Affective
196
Composed of the actual facts and words contained in the message; ex: ointment
Cognitive
197
Express feelings, emotions, attitudes, and behavior rather than words; can be more difficult
Affective
198
Over ____ communication is transmitted nonverbally
2/3
199
Identifying with the feelings, thoughts, or experiences of another person
Empathy
200
Verbal counterpart to occasional head nodding/nonverbal cues such as "yes, uh huh, and I see" and indicate the healthcare provider is listening to and understanding the patient
Minimal verbal responses
201
Healthcare provider is listening to an understanding the patient's concerns and perspectives; workers can reflect the specific content or implied feelings of their nonverbal communication they feel has been omitted or emphasized
Reflecting
202
Verbal statement that's interchangeable with a patient's statement
Paraphrasing
203
Open-ended statement used to obtain more information
Probing
204
Used to obtain more information about vague, ambiguous, or conflicting statements
Clarifying
205
Therapists are genuinely confused about their perceptions of the patient's verbal or nonverbal behavior or have a hunch something should be examined; verbal and nonverbal cues not adding up
Checking out
206
Therapist adds something to the patient's statement or tries to help the patient understand underlying feelings
Interpreting
207
Therapist shares objective and factual information; ex: low blood cell count
Informing
208
Therapists making the patient aware that their observations aren't consistent with the patient's words; response must be done with respect to the patient and extreme tact so that a defensive response isn't elicited
Confronting
209
Therapist condenses and puts in order the information communicated
Summarizing
210
Loss of appetite resulting in weight loss
Anorexia
211
Complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass; affects 1/2-2/3 of cancer patients
Cachexia
212
Cachexia causes issues with GI tract (irritated, sore, etc.) and is treated with IV fluids with glucose, amino acids, nutrients, vitamins, etc.
Hyperalimentation
213
3 types of malnutrition
Marasmus
Kwashiorkor
Combination
214
Calorie malnutrition causes fat and muscle to deplete in body resulting in weight loss of 7-10%
Marasmus
215
Protein malnutrition but have enough carbohydrates and fats characterized by retarded growth, muscles waste away, can see depigmentation in skin and hair, edema (ascites), and depressed immune system
Kwashiorkor
216
Most life threatening malnutrition characterized by weight loss of 10% or more
Depletes all protein in body and immune system deteriorates
Common in children
Combination
217
6 dimensions to consider in assessing and managing the experience of cancer pain
```
Physiologic
Sensory
Affective
Cognitive
Behavioral
Sociocultural
```
218
Organic cause of pain
Physiologic
219
Pain intensity, location and quality
Sensory
220
Depression and anxiety
Affective
221
Pain influences thought process and patient views themself in a different, usually negative way
Cognitive
222
Usually bad pain-related behaviors such as self medication-intake and dependence and lowered activity levels; irritable
Behavioral
223
Cultural background, being raised in certain culture/religion affects how patient deals with pain (ex: no medication)
Females and geriatrics vocalize pain more than others
Sociocultural
224
Assesses functional performance
Karnofsky scale
225
Decrease in the peripheral red blood cells
Anemia
226
Decrease in the white blood cells
Leukopenia
227
Reduction in the number of circulating platelets
Thrombocytopenia
228
Dynamic process directed toward the goal of enabling persons to function at their maximum level within their physical, mental, emotional, social and economic potential; need to consider the side effects of radiation
Rehabilitation
229
The perceived loss of self-esteem resulting in a cluster of affective behavioral (change in appetite, sleep disturbances, lack of energy, withdrawal, and dependency) and cognitive responses (decreased ability to concentrate, indecisiveness, and suicidal ideas)
Depression
230
Depression criteria: ___ or more symptoms present for ___ or more weeks
5 or more symptoms present for 2 or more weeks
231
9 criteria for depression
```
Depressed mood
Diminished interest or pleasure
Significant weight loss when not dieting or weight gain
Insomnia or hypersomnia
Psychometer agitation or retardation
Loss of energy or fatigue
Feelings of worthlessness
Diminished ability to think
Suicidal
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232
Holistic approach to patient care; encompasses a sense of fulfillment and connection with a power greater than oneself and a person's need to find satisfactory answers to questions that revolve around the meaning of life, illness, and death
Spiritual assesment
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Key concept and an essential ingredient in the religious and spiritual aspects of care and a major component in the healing process
Giving realistic support is a powerful gift oncology caregivers can offer to patient
Can help physically, emotionally, and physiologically
Hope
