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CNUR 204 > Unit 1 -Cancer + Eyes > Flashcards

Unit 1 -Cancer + Eyes Flashcards

(116 cards)

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1
Q

what is cancer

A

uncontrolled cell growth (proliferation) it is able to develop anywhere, effects all ages, sexes, ethinic groups, increased risk as you age

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2
Q

Hyperplasia

A

multiplication of cells due to increased cell division. Cell that normally die do not due to enzyme telomerase

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3
Q

Enzyme Telomerase

A

an enzyme that helps maintain the length of telomeres which are protective caps at the end of chromosomes. They shorten each time a cell divides and when the become too short the cell stops dividing or dies.

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4
Q

Metaplasia

A

The cell looks normal. Not the type of cells that are normally found in that tissue or area. A mature cell is replaces with another type of mature cell.

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5
Q

Dysplasia

A

Abnormal change in cells as they multiply- shape, size, appearance

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6
Q

Carcinoma

A

Maligant cells, can be insitu/invasive (in original place or not). Type of cancer that originates in epithelial cell, most common.

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7
Q

cancer patho cells

A

Normal, hyperplasia, mild dysphasia, carnoma in situ, cancer invasive

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8
Q

3 stages of cancer developement

A

initiation, promotion, progression

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9
Q

Initation of cancer developement

A

Mutation of the cell DNA during replication or carcinogen exposure, genetic markers.

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10
Q

Promotion of cancer development

A

Altered cell replication and continues to mutate this is preventable if caught in time

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11
Q

Progression of cancer developemnet

A

Tumour growth, tumour movement

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12
Q

Non modifiable risk factors

A

genetics, age, biological sex

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13
Q

Modifiable risk factors

A

carcinogen, exposure, obesity, smoking, alcohol nitrates, dietary fat

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14
Q

Do genetics have to so with cancer?

A

in some cases yes, for example women with BRCA1 or BRCA2 gene mutation have up to 85% chanace of developing breast cancer

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15
Q

Role of immune system in cancer

A

Recognize as foreign and Destry in cancer cells arizr from bodys own cells so see slow immune response as they do not see the threat as foreign

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16
Q

Cytotoxic T cells

A

slow tumour growth. They recognize and destroy cancer cells.

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17
Q

Natural Killer cells

A

Lyse cancer cells. Recognize and eliminate cancer cells without requiring prior activation by specific agents.

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18
Q

Macrophages

A

respond to tumour markers and destroy

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19
Q

B Lymphocytes

A

create antibodies to fight off inf, diseases this includes cancer

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20
Q

Tumour markers

A

tumour cells produces an antigen or marker in response to certain cancer cells. Can be found in the blood urine, tumoour tissue. May be utilized as a diagnosistic tool, as a baseline marker, a tool to monitor response to treatment and a sign of reccurence.

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21
Q

Types of tumour markers

A

AFP, CA125, CA19-9, CEA, HCG, PSA

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22
Q

How do cancer cells escape the immune system

A

Supress T cells, Escape the immune survalence, immune system decelops a tolerance to bad neighbours, supress teh immune sytem, blovk

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23
Q

Subjective assessment

A

fatigue, lump or thickened area, weight changes including unintended loss or gain, skin changes such as yellowing, darkening ir redness of the skin, changes in bowel or bladder habits, persistent cough or trouble breathing, diffculty swallowing, hoarseness, persistent indigestions, persistent unexplained muscle or joint pain, persistant unexplained fever or night sweats, unexplained belssing or bruising, family history of cancer

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24
Q

Ways to remember signs of an abnormal assessment

A

C: Changes in bowel/baldder habits
A: Sore that does not heal
U: Unualsal bleeding or discharge
T: Thicking or lump in breast or other places
I: Indigestion or difficulty swallowing
O:Obvious chnages in warts or moles
N: Nagging cough or persistent hoarseness
U: Unexplained weight loss
P: Pernicous Anemia

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25
Lab tests
Cytology (ex. Pap smear, looking at the shape of cells) Hematology, Chemistry, tumour markers
26
Diagnostic tests
Scope- gastroscopy, sigmoidoscopy, colonoscopy CT/MRI Mammogram Radio-isotope scans Genertic markers Bone marrow biopsy Biopsy Lumbar puncture
27
Biopsy Types
Needle Biopsy, Incisional biopsy, Excisional biopsy, Endoscopic Biopsy
28
Needle Biopsy
Cells and tissue fragement bone marrow (The needle into the spine)
29
Incisional biopsy
Punch of tissue (skin lesion, tissue sample) Skin cancer
30
Excisional Biopsy
REmoval of an entire tumour/ Mass
31
Endoscopic
GI, GU, Lungs
32
Cancer Stage 0
cancer in situe -Remove/monitor it
33
Cancer stage 1
Tumor limited to the tissue of organ, localized tumour
34
Cancer stage 2
Limited to local spread, with an orgin and does not exceed it
35
Stage 3 cancer
extensive local and regional spread
36
Stage 4 cancer
Metastasis, they spread
37
Nurses role in time of diagnosis
communicate, support, listen, relationship developement, answer question, explain
38
Do not do during time of diagnosis
"everything will be okay" , be impatient, rush through assessments
39
Metastasis
establishment of microenviornement spread throughout the body
40
What is TMN
T: extent of the tumour (size, number, location) N: Extent of spread to the lymph nodes M: Presence of metastasis
41
3 treatments
Cure, control, palpitation
42
Surgery and cancer
Remove tumour and surrounding tissue, cure localized cancer, ineffective if metastasis, follow up with radiation (Common in skin and thyroid)
43
Radiation
radiation releases free radicals free radials damage DNA and stop ability, uses high enefery radiation to shrink the tumour and kill cancer cells
44
Chemotherapy
Reformation of new blood vessels. Targets bone marrow, hair follicles, endothelial cells (any reproducing)
45
Ways to administer Chemotherapy
PO, IV< IM, Inter cavity, intrathecal, intra arterial, intra peritoneal, intra vesicular, SC
46
3 Principles of Cancer chemotherapy
Cytotoxic (Kills the cell) Cytostatic (Inhibit tumour growth) Induce cell differentiation
47
Complications from chemo
Fatigue, bone marrow suprression, WBC inf (neutropenia), GI cells stomatitis, Integrated cells, alopecia, RBC anemia, hepatoxicity, Nadir (lowest point a pateints RBC can go)
48
How does chemo cause this damage?
A number of blood cells that divide rapidly can be damaged along with cancer cells during chemo. WBC help protect the body from inf, low levels indicates neutropenia and is more likely to get infection. RBC carry oxygen throughout the body. Low levels is known as anemia. This leads to fatigue and more serious complications PLatelets are the structure that stops bleeding, low levels is called thrombocytopenia, can cause bruising and bleeding. Hair follicles are effected casuing alopecia Cells lining the stomach can be affected by chemo and can cause vomiting and diarreah
49
Lab chemistry
NA, K, Uream Creatinine
50
Immunotherapy
Cytokines, monoclonal antibodies, vaccine, gene therapy
51
Targeted therapy
Monoclonal antibodies, small molecules inhbitors, differentiang agents
52
when cancer is the invading agent the cancer cells are able to learn to
mimic the immune system and adapt to it, using immune mechanism to protect protect themselves
53
Cells in microenvironment
Dendritic, T cells, T regulatory cell, macrophages, natural killer cells, stomal cells
54
Objective nursing assessment
CNS, CVS, GI, Nutrition, GU, Inf, Endocrine, PAIN, Psychosocial
55
Interventions to do in cancer
Diagnose, treat, prevent spread, support, med: treat symptoms, cancer, complications
56
Referalls to use
omcology, socail work, PT, OT, Nutrition, Clinical psychology, Pallitive, Pain clinic, support groups, pharmacy
57
How to evaluate if treatment is working
Bloodwork, biopsy, ultrasound, follow up
58
Screening for breast cancer
mammogram, Takes images to detect any growth of tumours
59
Subjective assessment gor breast cancer
routine screening, health history, symptoms
60
Objective assessment breast cancer
General axillary and superclavicular lymphadenothy (lymph nodes), Integ change, Resp change, Jaundice, Ascites, hepatomegaly, reproductive
61
Male breast cancer
Usually found in the nipple area, hard nontender mass, more involvnment with lympnodes, e
62
Breast cancer medication
Estrogen receptor blockers, aromatase inhibitor, estrogen receptor modulator, biological targeted therapy
63
Environmental lung cancer risk factors
smoking, coal dust, air pollution, Radon gas, asbestos, ionizing radiation
64
Is lung cancer genetic
yes, some people are genetically predisposed
65
after the age of 55-74 what screening is done for cancer
Straight to treatment adter 75 years of age
66
subjective data for lung cancer
smoking, Asbestos exposure, occupational hazard, personal or family history of lung cancer, outdoor exposure to air pollution, exposure to radiation, immunocomprimised
67
objective assessment for lung cancer
integ, resp, cv, neuro, msk
68
non small lung cancers
account for most lung cancers Apenocarcinoma (periphery of lung, from goblet cell) Squamous cell carcinoma (centreally located from columnar epithelial cells that become squamous epithelial cells) -Unucual shape and squished in
69
Small cells lung cancer
not as common, centerally located, from small immature neuroendocrine cells
70
Therapy for lung cancer
surgical, radiation, chemo, biotherapy, meds, o2
71
Screening for prostate cancer
Starting at age 50 -PSA (prostate specific antigen blood test)(the finger, should feel like a tip of the nose), Digital rectal exam (done after PSA)
72
Subjective data assessment for prostate cancer
-Trouble urinating, age, sexual dysfunction, health history, symptoms
73
objective assessment for PRostatea cancer
general, urinary, MSK, PSA
74
treatement for Prostate cancer
conservative therapy (meds to treat the symptoms), Surgical therapy, radiation therapy, Androgen synthesis inhibitor and androgen receptor blocker
75
TURP
Transurethral resection fo the prostate (it blasts the prostate and sucks it out)
76
Subjective assessment
age 50 and older, ETOH (Over 4 drinks a week), IBS, smoking, polyps, Fx hx, Obesity, increased consumption of red meat.
77
screening for Colorectal cancer
Stool based FIT or gFOBT, Visual structural exams
78
Subjective data to collect for colorectal exam
health hx, weakness, fatigue, anorexia, weight loss, N and V, change in bowel habits, abd and lwo back pain
79
Age relation to cancer
increased changes with age
80
what is cataracts
Anythign that disrupts the crystalline lens fibre homeostasis eventually results in cataracts. Often age related, there is a crystalized lens that goes over the eyes.
81
What med can cause cataracts
cortocosteroids
82
what can cause cataracts
age, drugs, systematic illness such as diabetes, atopy, myotonic dystrophy, trauma, latrogen radiation, rential surgery
83
Symptoms of cataracts
Increasing difficulty with vision at night, sensitivty to light and glare, cloudy film over vision, seeing halo arounf light, frequent changes in eyeglassess or less, increasing nearsightedness, fading yellowing of colour, double vision in a single eye
84
Clinical presentation of cataracts
opacity within the lens, cortex, nuclear, sub scapular, dilation drops can help to see clearer
85
Risk factor for catarcts
increasing age, diabetes, excessive exposure to siunlight, smoking, obesity, previous injury or inflammation, previous eye surgery, prolonged use of corticosteroids, excessive alcohol
86
diagnostic test for cataracts
glare test, visual acuity drops significantly, clinical exam, biometry: Corneal curvature and a-scan ultrasound
87
Treatment for cataracts
perscription glasses, extra light for detailed near task, magnifying glasses, limit tasks that are need fine vision, avoid driving in the dark
88
possible complications for catarcts surgery
Infection 1:14000, posterior capsule rupture/dropeed nucleus1:1500 , rentinal detachement 1:500 , persistent swelling elevated 1:100 intracolular pressure 1:30-50
89
what is the most common cause of blindness in canada
age related macular degeneration
90
what is Dry atriphic AMD presentation
most common type 905, macular cell atrophy, slow adn progressive, painless, developement of drusen (yellow extracellular deposits)
91
Wet presentation (neovascular AMD, exudate AMD)
Visual disortion, such as straight lines seeming bent, sudden, painless, center at vision loss in one or both eyes, a well defined blurry spot in vision, general haziness in overal vision
92
Does macular degeneration effect peripheral vision
NO, so it often does in cause complete blindness
93
What is happening in wet exadative
Abupt onset of worsening symptoms, new blood vessel growth in chorids that bleed through rentinal pigment epithelium, vessels leak, scar tissue forms, untreated leads to blindness
94
Treatment for dry macular degeneration
smokinf cessation, sun protection, antiosidant suppliment, ARED 2 formula
95
Treatment for wet degeneration
intravitreal anti-vegf ing, Avastin, Lucentis, eylea -Lazer treatment for older people
96
Treatment for wet and dry degeneration
Low vision rehabilitation: Hand'/stand magnifiers, Microspcope, CCTV, Eccentric viewing lighting
97
Nursing management for Macular degeneration
MI (smoking cessation), Advocate continuing supplement during med reviews. FOr wet frequency is really important, assisting with low vision aids
98
Treatment frequency for wet AMD
Every 4 weeks x3 then treat and extend
99
What is glaucoma effecting
the optic nerve
100
Patho of glaucoma
Decreased ocular perfusion pressure, High IOP, Low BP or both -Ocular nerve atrophy -peripheral vision loss -High IOP occurs
101
What is the optic nerve
a bundle of more than 1 million nerve fibers that carry visual messages. You have one connecting the back of each eye (your retina) to your brain. Damage to an optic nerve can cause vision loss
102
Normal intraocular pressure
10-21 mmHg
103
Primary glaucoma vs secondary glaucoma
Primary open angle glaucoma: Most prevalent, angle open but fluid too slow Primary closure glaucoma: the drainage angle is blocked, causing a sudden or grdual rise in IOP Secondary open angle glaucoma: Exfoliation syndrome, pigmeent dispersion symndrome, storage weber syndrome Angle closure: ICE syndrome, choriodal effusion, tamoxifen
104
Risk factors for glaucoma
age, family history, sleep apnea, diabetes, steroids and other med, hyperthyroidism, hypertension, reynauds, migraine, topical steriods
105
Tests
Measuring intraocular pressure, testing for optic nerve damage, checking for areas of vision loss, measuring corneal thickness, inspecting the drainage angle
106
Symptoms of chronic glaucoma
difficulty with orientation adn mobility (bumping into things), pathchy blindness in periphery, tunnel vision
107
Acute angle glaucoma
Severe (11/10) headache and eye pain, N and V, Blurred vision, Halos around lights, eye redness
108
Treatment for glaucoma
-NEED treatment or they will go blind -Drops, surgery
109
Decrease aqeuous production treatment
Beta-blocker, alpha-adrenergic, carbonic anhydrase, inhibitor Surgery: lazer cycloabalation
110
Increase water aqueous outflow
Drops: prostaglandin Analogues, Nitric oxide, Muscarinic agonist, Rho Kinase Surgery: Selective laser trabeculoplasty, microinicisional drainage device, Trabeculectomy
111
Prostglandin eye drops
increase the outflow of the fluid within the eye and reduce pressure. Can cause mild redening, stinging, and changes in pigment aswell as blurred vision
112
Beta Blocker eye drops
these reduce the production of fluid in your eye, thereby lowering the pressure in your eye, possible side effects include difficulty breathing, slwoed heart rate, lower blood pressure, impotence and fatigue
113
Alpha adrenergic agonist eye drops
reduce the production of aqueos hummer. side effects include irregular heart rate, high bp, fatigue, red, itchy, swollen eyes
114
Miotic or collinergic agents
These increase the outflow of fluid from your eye. An example is pilocarpine. Side effects include smaller pupils, possible blurred vision or dim vision and brow ache. Rarely used for medical therapy
115
when does acute angle glaucoma become an emergency
when pressure goes over 70, vision can be lost within hours
116
what to do for someone in an acute glaucoma crisis
decrease aqeous production (timolol, bromonidine) admin IV mannitol, no PGA

CNUR 204 (5 decks)

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